Dear Editor-in-Chief, recent research has considered the utility of physical activity as a secondary prevention strategy for non-acute ischemic stroke (5-year poststroke) [1] and transient ischemic attack (TIA) patients (up to 12-month post-TIA diagnosis) [2]. Such research has demonstrated improvements in aerobic capacity and coronary artery disease (CAD) risk factors immediately following either a 10-week [1] or 6-month [2] exercise program. Despite these findings, little is known about the optimal time to engage new TIA patients in exercise and education programs, nor the short- or long-term response. Recent research from our laboratory has assessed the short-term efficacy of an 8-week exercise and education program on CAD risk factors and markers of fitness in newly diagnosed TIA patients [3]. Following a baseline assessment (CAD risk stratification, physical fitness examination), 60 TIA patients (recruited within 2 weeks of symptom onset) were randomized to either an 8-week exercise program or control group, with follow-up assessments noted immediately and 3-month post-intervention. Encouragingly, a greater improvement was observed in a number of CAD risk factors for those individuals who took part in the regular exercise and education sessions. Critically, these improvements were maintained even three months after the intervention (Fig. 1). As significant improvements in fitness were also identified, the early engagement in regular physical activity should be considered a useful additive treatment strategy for newly diagnosed TIA patients. Importantly, clinical trial investigations [3-5] are examining the long-term efficacy of exercise and education programs in modifying vascular risk in TIA patients. These studies may increase awareness concerning the importance of incorporating regular physical activity participation within secondary prevention programs for TIA patients.


Figure 1. Mean percentage (%) change in coronary artery disease (CAD) risk factors between baseline and 3-month post-intervention assessment for exercise and control participants. SBP, systolic blood pressure; DBP, diastolic blood pressure; TC, total cholesterol; HDL, high-density lipoprotein; FBG, fasting blood glucose; BMI, body mass index; WC, waist circumference; HC, hip circumference.

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  2. References
  • 1
    Lennon O, Carey A, Gaffney N, Stephenson J, Blake C. A pilot randomized controlled trial to evaluate the benefit of the cardiac rehabilitation paradigm for the non-acute ischaemic stroke population. Clin Rehabil 2008; 22:125133.
  • 2
    Prior PL, Hachinski V, Unsworth K et al. Comprehensive cardiac rehabilitation for secondary prevention after transient ischemic attack or mild stroke. Stroke 2011; 42:32073213.
  • 3
    Faulkner J, Lambrick D, Woolley B, Stoner L, Wong L, McGonigal G. A heath enhancing physical activity programme (HEPAP) for transient ischaemic attack and non-disabling stroke: recruitment and compliance. N Z Med J 2012; 125:19.
  • 4
    MacKay-Lyons M, Gubitz G, Giacomantonio N et al. Program of rehabilitative exercise and education to avert vascular events after non-disabling stroke or transient ischemic attack (PREVENT Trial): a multi-centred, randomised controlled trial. BMC Neurol [Article]. 2010; 10:122.
  • 5
    Lennon O, Blake C. Cardiac rehabilitation adapted to transient ischaemic attack and stroke (CRAFTS): a randomised controlled trial. BMC Neurol 2009; 9:9.