Blood pressure following resistance exercise in individuals in the chronic phase of stroke recovery

Q: What are the key findings of this study?

Acute leg-press resistance exercise produced no significant difference in post-exercise systolic blood pressure change between chronic stroke and non-stroke adults.

Q: What is the clinical evidence from this study?

Population: Chronic stroke recovery (n=30). Intervention: Single bout of leg-press resistance exercise in individuals with chronic stroke vs. Recreationally active non-stroke controls performing the same acute leg-press exercise. Primary outcome: Change in systolic blood pressure (SBP) from pre-exercise to within 1-minute post-exercise (MD 3.61 mmHg, 95% CI -8.36, 15.57, p=0.54).

Juliano Abreu; Elric Y. Allison; Kenneth S. Noguchi; Baraa K. Al‐Khazraji; Ada Tang

doi:10.64898/2026.09.18.26363411

October 1, 2026Open Access

Blood pressure following resistance exercise in individuals in the chronic phase of stroke recovery

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Key result

Acute resistance exercise produces similar post-exercise systolic blood pressure changes in stroke vs non-stroke adults.

MD 3.61 mmHg
95% CI -8.36, 15.57
P=0.54
n=30

Why the study?

Autonomic dysregulation after stroke can cause exaggerated exercise-induced blood pressure fluctuations, challenging perceptions about the safety and feasibility of resistance exercise during stroke recovery.

Does a single bout of lower body resistance exercise induce a greater reduction in systolic and diastolic blood pressure immediately post-exercise in individuals with chronic stroke compared to individuals without stroke?

Key Points

To evaluate and compare acute blood pressure changes immediately following a single bout of leg-press resistance exercise in individuals with chronic stroke versus healthy controls.
Included 11 individuals with chronic stroke (age 39–76 years, 5 female, 1–9 years post-stroke) and 19 recreationally active controls (age 18–33 years, 11 female).
Measured brachial artery blood pressure before and immediately after one set of 8 leg-press repetitions at a target rating of perceived exertion of 5–7 out of 10.
Analyzed between-group changes using independent t-tests and two-way ANCOVA adjusting for baseline blood pressure and physical activity levels.
Post-exercise change in systolic blood pressure showed no significant difference between groups (mean difference=3.61 mmHg, 95%CI:-8.36, 15.57, p=0.54).
Post-exercise change in diastolic blood pressure did not differ significantly between groups (mean difference=5.38 mmHg, 95%CI:-6.11, 16.86, p=0.35).
Between-group differences remained non-significant after controlling for baseline blood pressure and activity levels for systolic (p=0.08) and diastolic blood pressure (p=0.27).

Structured PICO

Does a single bout of lower body resistance exercise induce a greater reduction in systolic and diastolic blood pressure immediately post-exercise in individuals with chronic stroke compared to individuals without stroke?

P

Population

30 community-dwelling adults (11 with mild-to-moderate chronic stroke aged 39-76 years and 19 healthy recreationally active controls aged 18-33 years) evaluated immediately before and within 1 minute after a single bout of leg-press resistance exercise.

I

Intervention

Single acute bout of lower body resistance exercise consisting of 1 set of 8 repetitions of leg-press (90-degree horizontal leg press in the stroke group with target rating of perceived exertion 7/10 on modified Borg scale; 45-degree semi-recumbent leg press at 50% 1-repetition maximum in the non-stroke control group, achieving perceived exertion ~5/10).

C

Comparator

Comparison between individuals with chronic stroke (n=11) and healthy recreationally active controls without stroke (n=19) undergoing the matched acute leg-press exercise protocol.

O

Outcome

Change in brachial artery systolic blood pressure (SBP) and diastolic blood pressure (DBP) measured before exercise and immediately (within 1 minute) following a single set of 8 repetitions of leg-press exercise.surrogate

Main Result

Mean Difference: 3.61 (95% CI -8.36–15.57)

p-value: p=0.54

Individuals in the chronic phase of stroke recovery exhibit similar acute systolic and diastolic blood pressure responses immediately following a single low-to-moderate intensity set of leg-press resistance exercise compared to healthy non-stroke controls, providing preliminary support for the hemodynamic safety of resistance training in this population.

Limitations

Small sample size and not statistically powered
Groups were not age-matched (stroke group mean age 57.3 years vs non-stroke controls 22.8 years)
Stroke group had substantially higher physical activity levels than typical stroke populations
Single discrete post-exercise blood pressure measurement within 60 seconds rather than continuous beat-to-beat monitoring
Unable to statistically account for antihypertensive medication use in the stroke group (45%)
Slight postural differences between groups during the leg-press exercise (90-degree horizontal vs 45-degree semi-recumbent)
Perceived exercise intensity was relatively low (<5/10 RPE), which may not have been vigorous enough to elicit post-exercise hypotension
Groups were not age-matched due to convenience sampling at a university setting
Small sample size and not statistically powered, resulting in wide confidence intervals and inability to adjust for antihypertensive medication use
Stroke group had ~10 times higher weekly moderate-to-vigorous physical activity than typical stroke populations, limiting generalizability
Perceived exercise intensity was lower than prescribed (<5/10 vs 7/10) and may not have been vigorous enough to elicit a strong post-exercise hypotensive response
Post-exercise blood pressure was measured as a single discrete measurement within 60 seconds rather than continuous beat-to-beat or longer duration monitoring
Slight postural differences in leg press equipment between groups (90-degree horizontal in stroke vs 45-degree semi-recumbent in controls)

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Implication

Comparable acute blood pressure responses to leg-press exercise in chronic stroke and controls; leaves open generalizability to larger or more impaired stroke cohorts.

Abstract

Current evidence supports resistance training for stroke recovery but autonomic dysregulation following stroke can lead to exaggerated fluctuations in blood pressure (BP) in response to exercise, thus challenging perceptions about safety and feasibility of resistance exercise. This study compared the post-exercise BP response following a single bout of leg-press exercise between people with and without stroke. Data from 11 individuals with chronic stroke (age 39-76 years, 5 female, 1-9 years post-stroke) and 19 recreationally active controls (age 18-33 years, 11 female) were included. Brachial artery BP was measured before exercise and immediately following a single set of leg-press (8 repetitions, target rating of perceived exertion 5-7/10). The difference between pre- and post-exercise BP was calculated and compared between groups using an independent t-test of equal variance. Additionally, a two-way analysis of covariance was used to examine potential cofounding effects of activity level and baseline BP on between group differences in BP response. No group differences were observed in post-exercise change in systolic (mean difference=3.61 mmHg, 95%CI:-8.36, 15.57, p=0.54); and diastolic (mean difference=5.38 mmHg, 95%CI:-6.11, 16.86, p=0.35) BP. Results were unchanged after controlling for baseline BP, and activity levels. Our work suggests that individuals with and without chronic stroke experience similar acute BP responses immediately following resistance exercise; however, work with more appropriately matched controls and greater sample sizes is needed to support these findings. Future studies may elucidate mechanisms related to the acute cardiovascular response to resistance exercise in individuals with stroke.

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Cite This Study

Abreu et al. (2026) studied Chronic stroke recovery (n=30). Single bout of leg-press resistance exercise in individuals with chronic stroke vs. Recreationally active non-stroke controls performing the same acute leg-press exercise was evaluated on Change in systolic blood pressure (SBP) from pre-exercise to within 1-minute post-exercise (MD 3.61 mmHg, 95% CI -8.36, 15.57, p=0.54). Acute leg-press resistance exercise produced no significant difference in post-exercise systolic blood pressure change between chronic stroke and non-stroke adults.

synapsesocial.com/papers/6ae28dedcbadf70daf6c3fd6 https://doi.org/10.64898/2026.09.18.26363411

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Blood pressure following resistance exercise in individuals in the chronic phase of stroke recovery

Key Points

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Blood pressure following resistance exercise in individuals in the chronic phase of stroke recovery

Key Points

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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