In 2007, Ivey, et. al., conducted study about Insulin resistance and glucose intolerance which are prevalent among individuals post-stroke, elevating the risk of cardiovascular complications and recurrent stroke. Recent research indicates that treadmill exercise training (T-AEX) could enhance aerobic capacity in chronic stroke patients, hinting at its potential to positively impact glucose metabolism. In this study, we aimed to investigate the effects of a progressive T-AEX program compared to an attention-matched stretching intervention (CONTROL) on glucose tolerance and insulin sensitivity in stroke survivors.

Participants in this study exhibited hemiparetic gait following ischemic stroke that occurred more than six months prior. They were randomly assigned to either a six-month T-AEX intervention or a CONTROL program involving supervised stretching exercises. Key outcome measures included glucose and insulin responses during a 3-hour oral glucose tolerance test (OGTT).

Forty-six subjects (26 in T-AEX group and 20 in CONTROL group) completed OGTT testing before and after the interventions. T-AEX led to a significant increase in aerobic capacity (Vo2 peak) compared to CONTROL (+15% versus -3% Delta, P<0.01). Furthermore, significant reductions were observed in fasting insulin levels (-23% versus +9% Delta, P<0.05) and the total integrated 3-hour insulin response (-24% versus +3% Delta, P<0.01) in the T-AEX group compared to CONTROL. Among patients with abnormal glucose tolerance at baseline, T-AEX resulted in a notable 14% decrease in the 3-hour glucose response (n=12, P<0.05). Remarkably, 58% of T-AEX participants with impaired baseline OGTT (7 out of 12) exhibited improved glucose tolerance status at 2 hours, compared to less than 10% (1 out of 11) in the impaired CONTROL group (P<0.05).

These initial findings suggest that progressive aerobic exercise could mitigate insulin resistance and potentially prevent diabetes in hemiparetic stroke survivors. However, larger-scale clinical trials are warranted to conclusively establish the efficacy of structured exercise training in driving metabolic improvements post-stroke

Reference: Ivey, F. M., Ryan, A. S., Hafer-Macko, C. E., Goldberg, A. P., & Macko, R. F. (2007). Treadmill aerobic training improves glucose tolerance and indices of insulin sensitivity in disabled stroke survivors: a preliminary report. Stroke, 38(10), 2752-2758.