Stroke rehab: relaxation therapy better than endurance training

Stroke rehab: relaxation therapy better than endurance training

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Important post-stroke rehabilitation: relaxation or treadmill?

Around 270,000 strokes occur in Germany every year. Affected patients must go to hospital immediately for acute treatment. Then in most cases it goes to rehabilitation. But which form of rehab has a better chance of success? German researchers have now dealt with this question.

Worldwide, ten million people suffer a stroke every year. In Germany, more than a quarter of a million people are affected by a so-called brain attack. Advances in stroke therapy are leading to better and better survival. However, this also increases the number of patients who have to live with permanent disabilities after a stroke. At least a third of those affected do not fully recover functionally. Rehabilitation is therefore becoming increasingly important. However, there are no medications available to support rehabilitation effectively.

After a stroke, "less is maybe more"

As the University Medical Center Greifswald (UMG) explains in a communication, the data on promising training methods is currently contradictory. The endurance training recommended by the American professional associations was shown in the current study "PHYS-STROKE" under the direction of the director of the neurological clinic at the UMG, Professor Dr. Agnes Flöel, not superior to relaxation therapy. Rather, the new data indicate that in the early phase after a stroke there is "less maybe more". The study results were published in the "British Medical Journal".

Intensive physiotherapy and occupational therapy

In the case of a stroke, “there is a lack of blood flow to the areas of the brain behind it and thus a reduced supply of oxygen and nutrients. Depending on the brain region concerned, this can lead to disorders or failures of various bodily functions and often permanent disabilities, ”explains the German Stroke Help Foundation on its website.

According to experts, attention and concentration deficits, often associated with gaps in memory and planning disorders, are among the most common neuropsychological functional disorders after a stroke. In addition, there are often speech or visual disorders. Health experts advise sufferers to seek professional help. Outside of neurological rehabilitation clinics, resident neuropsychologists are the first address.

According to the UMG, the rehab treatment mainly consists of intensive physiotherapy and occupational therapy and, in the case of speech disorders, in speech therapy and neuropsychological measures. Targeted treadmill training can improve speed and endurance when walking and climbing stairs. The data on the results of such a stroke rehab is contradictory.

"In general, the studies are difficult to compare due to the differences in terms of type, intensity and time of the start of training," said Prof. Dr. Agnes Flöel. "Especially for patients in the early phase after a stroke, there is still uncertainty as to which training is optimal."

Treadmill training is not superior to relaxation training

As part of the German study "PHYS-STROKE" ("Physical Fitness Training in Patients with Subacute Stroke"), the effects of aerobic treadmill training beginning in the early phase after a stroke were examined in seven inpatient rehabilitation clinics from 2013 to 2017.

200 adult stroke patients with an average age of 69 years participated in the study. The study group with 105 subjects completed aerobic treadmill training in addition to the standard rehabilitation measures, the control group with 95 subjects took part in relaxation units in addition to the standard rehabilitation measures. Each group completed the training five times a week, 25 minutes each, for a total of four weeks.

"In summary, the early four-week treadmill training was not superior to relaxation training in terms of maximum walking pace and everyday fitness after three months," said Prof. Martin Ebinger from Medical Park Berlin Humboldtmühle, who was involved in the planning and implementation of the study.

“The data available therefore suggest that aerobic training should not be forced in the subacute phase after stroke in moderately to severely affected patients. However, patients who are more easily affected may benefit earlier. This question must be investigated in future studies so that concrete recommendations can be made for this group. ”(Ad)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.


  • Universitätsmedizin Greifswald (UMG): New insights into stroke rehabilitation: relaxation better than treadmill training ?, (access: September 21, 2019), Universitätsmedizin Greifswald (UMG)
  • British Medical Journal: Physical Fitness Training in Patients with Subacute Stroke (PHYS-STROKE): multicentre, randomized controlled, endpoint blinded trial, (access: 21.09.2019), British Medical Journal
  • German Stroke Aid Foundation: What is a Stroke ?, (accessed: 09/21/2019), German Stroke Aid Foundation

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