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Background <p>Very early exercise (VEE) after stroke has shown short-term benefits on clinical recovery and inflammation; however, its long-term effects on real-world outcomes remain underexplored. This study evaluated whether initiating rehabilitation within 24&#xa0;h of ischaemic stroke provides sustained benefits in return to work (RTW), work ability (WA), community participation (CP), and health-related quality of life (HRQoL), compared with delayed exercise (DE) at one year post-stroke.</p> Methods <p>In the original randomised controlled trial (Pan African Clinical Trial Registry: PACTR202406755848901), 48 patients with first-ever mild-to-moderate ischaemic stroke were randomised (1:1) to VEE (within 24&#xa0;h of onset) or DE (after one week), followed by an identical 3-month, 90-min, progressive supervised exercise program. In this one-year observational follow-up, 41 participants (21 VEE; 20 DE) were reassessed on RTW status (full-time or part-time), Work Ability Index (WAI)<b>,</b> social participation domain of the Stroke Impact Scale (SIS), and overall SIS scores.</p> Results <p>At one year, a higher proportion of participants in VEE successfully returned to work, though the difference was not statistically significant (61.9% vs. 40.0%; <i>p</i> = 0.161). VEE participants resumed work significantly earlier (4.96 ± 0.99 vs. 6.50 ± 1.19&#xa0;months; <i>p</i> = 0.005) and demonstrated significantly higher WAI scores (6.24 ± 2.43 vs. 4.35 ± 2.72; <i>p</i> = 0.024). They also reported greater CP and HRQoL, with significantly higher scores in the SIS social participation domain (62.7 ± 19.8 vs. 48.6 ± 16.5; <i>p</i> = 0.018) and overall SIS scores (65.9 ± 16.9 vs. 55.3 ± 14.5; <i>p</i> = 0.038).</p> Conclusion <p>These findings suggest that VEE may confer meaningful long-term advantages in occupational reintegration, participation, and quality of life. Integrating VEE into stroke rehabilitation protocols could enhance functional recovery and societal reintegration.</p>

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Long-term impact of very early exercise after ischaemic stroke on return to work, participation, and quality of life: a one-year follow-up of a randomised controlled trial

  • 期刊论文

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  • 发表日期：

    2025年10月13日

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  • Adekola B. Ademoyegun,
  • Oluwatobi I. Awogboro,
  • Emmanuel T. Ojo,
  • Adebukola G. Ibitoye,
  • Marufat O. Odetunde,
  • Taofeek O. Awotidebe

摘要

Background

Very early exercise (VEE) after stroke has shown short-term benefits on clinical recovery and inflammation; however, its long-term effects on real-world outcomes remain underexplored. This study evaluated whether initiating rehabilitation within 24 h of ischaemic stroke provides sustained benefits in return to work (RTW), work ability (WA), community participation (CP), and health-related quality of life (HRQoL), compared with delayed exercise (DE) at one year post-stroke.

Methods

In the original randomised controlled trial (Pan African Clinical Trial Registry: PACTR202406755848901), 48 patients with first-ever mild-to-moderate ischaemic stroke were randomised (1:1) to VEE (within 24 h of onset) or DE (after one week), followed by an identical 3-month, 90-min, progressive supervised exercise program. In this one-year observational follow-up, 41 participants (21 VEE; 20 DE) were reassessed on RTW status (full-time or part-time), Work Ability Index (WAI), social participation domain of the Stroke Impact Scale (SIS), and overall SIS scores.

Results

At one year, a higher proportion of participants in VEE successfully returned to work, though the difference was not statistically significant (61.9% vs. 40.0%; p = 0.161). VEE participants resumed work significantly earlier (4.96 ± 0.99 vs. 6.50 ± 1.19 months; p = 0.005) and demonstrated significantly higher WAI scores (6.24 ± 2.43 vs. 4.35 ± 2.72; p = 0.024). They also reported greater CP and HRQoL, with significantly higher scores in the SIS social participation domain (62.7 ± 19.8 vs. 48.6 ± 16.5; p = 0.018) and overall SIS scores (65.9 ± 16.9 vs. 55.3 ± 14.5; p = 0.038).

Conclusion

These findings suggest that VEE may confer meaningful long-term advantages in occupational reintegration, participation, and quality of life. Integrating VEE into stroke rehabilitation protocols could enhance functional recovery and societal reintegration.