Abstract Details

Title Efficacy of Exercise Interventions for Autonomic and Cardiovascular Dysfunction in Chronic Ischemic Stroke: A Systematic Review and Meta-analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P9 - Poster Session 9 (5:00 PM-6:00 PM)

Poster/Presentation
Number 5-020

Objective To evaluate the efficacy of exercise interventions on autonomic and cardiovascular outcomes in chronic ischemic stroke survivors for secondary prevention.

Background Autonomic and cardiovascular dysfunction are common post-ischemic stroke complications, heightening recurrence risk and impairing recovery.These issues, including altered heart rate variability and hypertension, necessitate effective interventions.Despite growing interest in autonomic regulation and secondary prevention, evidence remains inconsistent.This systematic review and meta-analysis assessed therapeutic interventions’ efficacy in chronic ischemic stroke survivors, addressing a critical gap in stroke management.

Design/Methods We conducted a systematic review and meta-analysis of randomized and observational studies evaluating autonomic or cardiovascular outcomes post-stroke.The study adhered to PRISMA 2020 guidelines and the Cochrane Handbook for Systematic Reviews of Interventions.Searches of PubMed, Embase, Scopus, Cochrane Library, and ClinicalTrials.gov were performed up to July 2025.Analyses in RStudio used a random-effects model, reporting mean differences (MD) with 95% confidence intervals (CI).Heterogeneity was assessed via I² and Cochran’s Q tests.Risk of bias was evaluated using the ROB 2 tool for randomized trials and the Newcastle–Ottawa Scale for observational studies.Sensitivity analysis employed leave-one-out meta-analysis for high heterogeneity.

Results From 2,134 records, 1,684 were screened after duplicate removal. Of 49 full-text reports, 6 met inclusion criteria and were included in the analysis.The random-effects model showed modest improvements:peak VO2 by 1.09 L/min (95% [CI: 0.29–1.90]), resting SBP by 1.30 mmHg (95% [CI: -1.39–4.00]), resting DBP by 0.87 mmHg (95% [CI: -0.78–2.51]), and six-minute walking distance by 2.74 meters (95% [CI: -6.20–11.69]).Heterogeneity was high for peak VO2 (I² = 90.0%) but low for walking distance (I² = 0.0%).Leave-one-out analysis for peak VO2 confirmed stability (MD: 0.71–1.65 L/min).

Conclusions This Meta-Analysis indicates therapeutic interventions modestly improve cardiovascular and functional outcomes post-stroke, with significant peak VO2 gains.Stable sensitivity results despite high heterogeneity suggest potential efficacy, supporting their role in secondary prevention.Larger, high-quality trials are needed to validate findings and reduce variability.

Authors/Disclosures
Hafiz Sohail Ashraf, MD PRESENTER	Dr. Ashraf has nothing to disclose.
Rida Shakeel, MBBS	Dr. Shakeel has nothing to disclose.
Muhammad Abdullah, MD	Dr. Abdullah has nothing to disclose.
Anas Mansour, MD	Dr. Mansour has nothing to disclose.
Jawad Basit, MBBS	Dr. Basit has nothing to disclose.
Wajdan Ahmad, MBBS	Mr. Ahmad has nothing to disclose.
MUHAMMAD AHMED HAROON JANJUA, MBBS	Dr. JANJUA has nothing to disclose.
Haadi U. Rehman, MBBS	Dr. Rehman has nothing to disclose.
Ezza Bashir, MD	Dr. Bashir has nothing to disclose.
Sohaib Aftab Ahmad Chaudhry, MBBS	Dr. Chaudhry has nothing to disclose.
Immad Muhammad Usman, MBBS	Dr. Muhammad Usman has nothing to disclose.
Huzaifa S. Nawaz, MBBS	Dr. Nawaz has nothing to disclose.

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