Post-stroke exercise rehabilitation: What we know about retraining the motor system and how it may apply to retraining the heart

■ ABSTRACT A plateau in recovery within the first few months of rehabilitative therapy was assumed to be the norm in stroke survivors. Recent studies in our laboratory examined the effect of 6 months of treadmill exercise training in chronically disabled stroke survivors. Treadmill exercise improves fitness and walking ability in patients when initiated 6 months or more following their index stroke. Functional imaging studies show that such exercise also induces subcortical reorganization in these patients. Future investigations will explore the relationship between these functional and structural effects and characterize the therapeutic mechanisms of post-stroke rehabilitation. Nonetheless, treadmill exercise appears to have motor, cardiac, and daily functional benefits in stroke survivors.