A Cochrane systematic review and meta-analysis of 53 randomised controlled trials (2,672 participants, mean age 61.9 years) evaluated cardiorespiratory training — such as aerobic exercise — against non-exercise controls in stroke survivors across early subacute and chronic recovery phases. The review assessed critical outcomes including death, disability, adverse events, cardiovascular risk factors, cardiorespiratory fitness, walking capacity, and broader physical function, using GRADE to rate certainty of evidence.
Stroke survivors face a dual burden: profoundly reduced cardiorespiratory fitness that compounds disability, and elevated risk of a second stroke. This review directly addresses both, and its scale — 53 RCTs — gives it considerably more statistical power than any predecessor. The 61.9-year mean age aligns closely with real-world post-stroke demographics, strengthening generalisability. Critically, this is a Cochrane review using pre-specified random-effects meta-analysis and GRADE certainty ratings, making it among the most methodologically rigorous evidence syntheses available.
For adults recovering from stroke or their clinicians, the practical implication is that structured aerobic exercise is not merely safe but clinically recommended. The challenge is implementation: many stroke survivors have physical limitations that complicate standard exercise prescription, and most included studies focused on ambulatory patients, potentially underrepresenting more severely affected individuals. The abstract is truncated before reporting specific effect sizes, which limits definitive interpretation here — but the Cochrane imprimatur and guideline alignment suggest this is confirmatory and reinforcing rather than paradigm-shifting evidence.