Experiences of participation in cardiorespiratory training among people with post-stroke fatigue: a qualitative study

Authors

  • Maria Svedjebrant Centre for Research and Development, Region Gävleborg/Uppsala University, Uppsala, Sweden; Faculty of Medicine and Health, Örebro University, Örebro, Sweden
  • Anna Bråndal Department of Public Health and Clinical Medicine and Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
  • Ylva Nilsagård Faculty of Medicine and Health, Örebro University, Örebro, Sweden; University Healthcare Research Centre, Region Örebro, Sweden

DOI:

https://doi.org/10.2340/jrm.v57.42282

Keywords:

cerebrovascular disorders, post-stroke fatigue, cardiorespiratory training, qualitative study, physiotherapy

Abstract

Objective: To explore the experiences of 8-week thrice-weekly supervised intense cardiorespiratory interval training at home in people with post-stroke fatigue.

Design: Qualitative, using semi-structured individual interviews.

Methods: Eleven people with post-stroke fatigue were recruited from a study investigating the effects of supervised intense cardiorespiratory interval training. The interviews were conducted 1–2 weeks after the intervention period and analysed inductively with qualitative content analysis.

Results: The theme “Supervised cardiorespiratory interval training at home was perceived as feasible and safe, reducing fatigue and contributing to enhanced self-efficacy in both exercise and everyday life” was based on 4 main categories: “Experiences of performing the intervention and testing, “Perceived impact of the intervention on fatigue”, “Perceived impact of the intervention on self-efficacy”, and “The reinforcing experiences of exercise transfer to everyday life”. The informants reported that participating in the intervention made them feel physically and mentally stronger and no longer restricted by a lack of confidence in performing activities that increased their heart rate.

Conclusions: Participating in supervised intense cardiorespiratory interval training provided a model on how to train, which was transferable to other contexts in everyday life. The training improved exercise self-efficacy and gave the informants the confidence to challenge themselves in everyday life.

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References

Mead GE, Sposato LA, Sampaio Silva G, Yperzeele L, Wu S, Kutlubaev M, et al. A systematic review and synthesis of global stroke guidelines on behalf of the World Stroke Organization. Int J Stroke 2023; 18: 499–531.

https://doi.org/10.1177/17474930231156753 DOI: https://doi.org/10.1177/17474930231156753

Hannan AL, Hing W, Simas V, Climstein M, Coombes JS, Jayasinghe R, et al. High-intensity interval training versus moderate-intensity continuous training within cardiac rehabilitation: a systematic review and meta-analysis. Open Access J Sports Med 2018; 9: 1–17.

https://doi.org/10.2147/OAJSM.S150596 DOI: https://doi.org/10.2147/OAJSM.S150596

Steen Krawcyk R, Vinther A, Petersen NC, Faber J, Iversen HK, Christensen T, et al. Effect of home-based high-intensity interval training in patients with lacunar stroke: a randomized controlled trial. Front Neurol 2019; 10: 664.

https://doi.org/10.3389/fneur.2019.00664 DOI: https://doi.org/10.3389/fneur.2019.00664

Regan EW, Handlery R, Stewart JC, Pearson JL, Wilcox S, Fritz S. Feasibility of integrating survivors of stroke into cardiac rehabilitation: a mixed methods pilot study. PLoS One 2021; 16: e0247178.

https://doi.org/10.1371/journal.pone.0247178 DOI: https://doi.org/10.1371/journal.pone.0247178

Hillsdon KM, Kersten P, Kirk HJ. A qualitative study exploring patients’ experiences of standard care or cardiac rehabilitation post minor stroke and transient ischaemic attack. Clin Rehabil 2013; 27: 845–853.

https://doi.org/10.1177/0269215513478956 DOI: https://doi.org/10.1177/0269215513478956

Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004; 24: 105–112.

https://doi.org/10.1016/j.nedt.2003.10.001 DOI: https://doi.org/10.1016/j.nedt.2003.10.001

Borg G. Borg’s perceived exertion and pain scales. Champaign, IL: Human Kinetics; 1998.

Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53: 695–699.

https://doi.org/10.1111/j.1532-5415.2005.53221.x DOI: https://doi.org/10.1111/j.1532-5415.2005.53221.x

Brandal A, Eriksson M, Wester P, Lundin-Olsson L. Reliability and validity of the Swedish Fatigue Assessment Scale when self-administered by persons with mild to moderate stroke. Top Stroke Rehabil 2016; 23: 90–97.

https://doi.org/10.1080/10749357.2015.1112057 DOI: https://doi.org/10.1080/10749357.2015.1112057

Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 2007; 19: 349–357.

https://doi.org/10.1093/intqhc/mzm042 DOI: https://doi.org/10.1093/intqhc/mzm042

Delbridge A, Davey J, Galloway M, Drummond A, Lanyon L, Olley N, et al. Exploring post-stroke fatigue from the perspective of stroke survivors: what strategies help? A qualitative study. Disabil Rehabil 2024; 46: 4187–4193.

https://doi.org/10.1080/09638288.2023.2266363 DOI: https://doi.org/10.1080/09638288.2023.2266363

Prout EC, Mansfield A, McIlroy WE, Brooks D. Physiotherapists’ perspectives on aerobic exercise early after stroke: a preliminary study. Physiother Theory Pract 2016; 32: 452–460.

https://doi.org/10.1080/09593985.2016.1204402 DOI: https://doi.org/10.1080/09593985.2016.1204402

Lennon O, Crystal A, Kwan M, Tierney C, Gallagher A, Murphy S. Perspectives and experiences of cardiac rehabilitation after stroke: a qualitative study. Healthcare (Basel) 2022; 10: 1579.

https://doi.org/10.3390/healthcare10081579 DOI: https://doi.org/10.3390/healthcare10081579

Sammut M, Haracz K, English C, Shakespeare D, Crowfoot G, Nilsson M, et al. Participants’ perspective of engaging in a gym-based health service delivered secondary stroke prevention program after TIA or mild stroke. Int J Environ Res Public Health 2021; 18: 11448.

https://doi.org/10.3390/ijerph182111448 DOI: https://doi.org/10.3390/ijerph182111448

Faux SG, Arora P, Shiner CT, Thompson-Butel AG, Klein LA. Rehabilitation and education are underutilized for mild stroke and TIA sufferers. Disabil Rehabil 2018; 40: 1480–1484.

https://doi.org/10.1080/09638288.2017.1295473 DOI: https://doi.org/10.1080/09638288.2017.1295473

Marzolini S, Tang A, McIlroy W, Oh PI, Brooks D. Outcomes in people after stroke attending an adapted cardiac rehabilitation exercise program: does time from stroke make a difference? J Stroke Cerebrovasc Dis 2014; 23: 1648–1656.

https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.01.008 DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.01.008

Hugues N, Pellegrino C, Rivera C, Berton E, Pin-Barre C, Laurin J. Is high-intensity interval training suitable to promote neuroplasticity and cognitive functions after stroke? Int J Mol Sci 2021; 22: 3003.

https://doi.org/10.3390/ijms22063003 DOI: https://doi.org/10.3390/ijms22063003

Linder SM, Lee J, Bethoux F, Persson D, Bischof-Bockbrader A, Davidson S, et al. An 8-week forced-rate aerobic cycling program improves cardiorespiratory fitness in persons with chronic stroke: a randomized controlled trial. Arch Phys Med Rehabil 2024; 105: 835–842.

https://doi.org/10.1016/j.apmr.2024.01.018 DOI: https://doi.org/10.1016/j.apmr.2024.01.018

Dromerick A, Geed S, Barth J, Brady K, Giannetti M, Mitchell A, et al. Critical Period After Stroke Study (CPASS): a phase II clinical trial testing an optimal time for motor recovery after stroke in humans. Proc Natl Acad Sci U S A 2021; 118: e2026676118.

https://doi.org/10.1073/pnas.2026676118 DOI: https://doi.org/10.1073/pnas.2026676118

Tai D, Falck RS, Davis JC, Vint Z, Liu-Ambrose T. Can exercise training promote better sleep and reduced fatigue in people with chronic stroke? A systematic review. J Sleep Res 2022; 31: e13675.

https://doi.org/10.1111/jsr.13675 DOI: https://doi.org/10.1111/jsr.13675

Prout EC, Mansfield A, McIlroy WE, Brooks D. Patients’ perspectives on aerobic exercise early after stroke. Disabil Rehabil 2017; 39: 684–690.

https://doi.org/10.3109/09638288.2016.1161833 DOI: https://doi.org/10.3109/09638288.2016.1161833

Nicholson S, Sniehotta FF, van Wijck F, Greig CA, Johnston M, McMurdo ME, et al. A systematic review of perceived barriers and motivators to physical activity after stroke. Int J Stroke 2013; 8: 357–364.

https://doi.org/10.1111/j.1747-4949.2012.00880.x DOI: https://doi.org/10.1111/j.1747-4949.2012.00880.x

Graneheim UH, Lindgren BM, Lundman B. Methodological challenges in qualitative content analysis: a discussion paper. Nurse Educ Today 2017; 56: 29–34.

https://doi.org/10.1016/j.nedt.2017.06.002 DOI: https://doi.org/10.1016/j.nedt.2017.06.002

Additional Files

Published

2025-04-16

How to Cite

Svedjebrant, M., Bråndal, A., & Nilsagård, Y. (2025). Experiences of participation in cardiorespiratory training among people with post-stroke fatigue: a qualitative study. Journal of Rehabilitation Medicine, 57, jrm42282. https://doi.org/10.2340/jrm.v57.42282

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