ABSTRACT NUMBER: ESOC2026A1056 HOME-BASED SUPERVISED CARDIORESPIRATORY INTERVAL TRAINING DECREASES POST-STROKE FATIGUE AND IMPROVES CARDIORESPIRATORY FITNESS—A RANDOMIZED CONTROLLED TRIAL

Abstract Background and aims Post-stroke fatigue (PSF) is prevalent, impacting nearly half of stroke survivors and limiting recovery and daily life. Currently, no proven treatment exists. Reduced cardiorespiratory fitness may contribute to PSF, making aerobic exercise a potential therapeutic option. Methods We performed a two-center, randomized, open-label trial with blinded outcome assessment to investigate a home-based, supervised cardiorespiratory interval training program (HS-CITP) in individuals with PSF (Swedish Fatigue Assessment Scale [S-FAS] ≥28) within 1–7 months post-stroke. Participants were assigned (1:1) to HS-CITP or usual care involving self-directed activity after early supported discharge. The intervention included 40-minute cycling sessions, three times weekly for eight weeks, at 70–80% of maximum heart rate. The trial was powered to detect a 9-point difference in S-FAS scores. Primary outcome: fatigue (S-FAS); secondary outcome: peak oxygen uptake (VO₂peak, mL/kg/min). Results Forty-five participants were randomized; 43 completed follow-up (HS-CITP: n = 22; control: n = 21). HS-CITP adherence was 92%, with no adverse events. Compared with controls, HS-CITP significantly reduced fatigue (mean difference − 5.35 points; 95% CI −9.03 to −3.67; P < 0.001) and improved VO₂peak (+4.48 mL/kg/min; 95% CI 3.41–5.54; P < 0.001). Conclusions Home-based supervised interval training effectively reduced PSF and enhanced fitness, with high adherence and safety. These results support incorporating structured aerobic exercise into stroke rehabilitation. Larger randomized controlled trials should confirm long-term effects and explore alternative exercise modalities and timing. Conflict of interest Anna Bråndal, nothing to disclose. Maria Svedjebrant, nothing to disclose. Ylva Nilsagård, nothing to disclose. Per Wester: PW reports fees as a Clinical Events Committee member from Abbott, and is a member of the steering committee of Riksstroke, the Swedish Stroke Register and EVAS, the Swedish Endovascular Register.