Table 1: Scores for methodological quality of studies included in the review

Study and Year PEDro Score Downs and Black score

El Tamaway MS et al (2014) 15/28 (fair)

Cui ZP (2016) 6/10 (good)

De Morais VAC et al (2017) 17/28 (fair)

Cichon N et al (2018) 6/10 (good)

Boyne P, et al (2018) 22/28 (good)

Chang WC (2018) 17/28 (fair)

Chaturvedi P et al (2018) 6/10 (good)

King M et al (2019) 17/28 (fair)

Hsu CC et al (2020) 6/10 (good)

Table 2: Description of demographics and results of included studies

First Author Study type Participants Intervention (CG/IG) Dosage Outcome measures Conclusion
Year Country Measurement time Patient compliance
Randomisation Drop outs
El Tamaway MS et al Clinical Controlled 30 subacute stroke Out patient based CG: 25 minutes per Measure of cognition Aerobic exercises can
(2014) 36 Trial patients in the territory training session for three Addenbrooke’s Cogni- improve cognitive
Egypt of anterior circulation CG: N=15 consecutive days for tive Examination- functions in sub acute
No Randomisation with post stroke period Conventional eight weeks Revised (ACER) ischemic stroke
of 3-18 months and physiotherapy program IG: 25-20 minutes subjects which is
mean age of 48.4 + followed by rest period Measure of brain related with the
6.39 years. IG: N=15 for 10-15 minutes neural plasticity increase in serum
Conventional followed by aerobic Serum BDNF analysis BDNF.
physiotherapy program exercise on bicycle using ELISA
followed by aerobic ergometer for 40-45
exercises minutes for eight weeks No drop outs
T0: Baseline
T1: After eight weeks
Cui ZP RCT 150 stable acute stroke In patient based CG: Conventional Measure of motor The early rehabilitation
(2016) 37 China patients in the territory training routine neurological function training proved to be
Simple Randomisation of anterior circulation CG: N= 75 treatment for 14 days Fugl Mayer Assesment effective and regulates
with post stroke period Routine neurological IG: 1 time/d,45–60 BDNF levels and
of < 48 hours and treatment min/time, for 14 d Measure of functional promotes motor and
were in the age group T0: Baseline recovery functional recovery
of 46-76 years. IG: N= 75 T1: After two weeks Modified Barthel Index
Early rehabilitation T2: After four weeks
program Measure of brain
neural plasticity
Serum BDNF analysis
using ELISA

No drop outs

De Morais VAC et al Patient Cohort Trial 22 chronic stroke Out patient based 30-min in the target Measure of cognition 30 min of acute aerobic
(2017) 38 Brazil subjects with post training training zone (mild Mini Mental State exercise at a moderate
No Randomisation stroke period of at least N= 10 completed both intensity, 50–63% of Examination intensity, increases
6 months and the mean the pre and post maximum heart rate, Measure of serum BDNF in the
age of 58.0 ± 12.8. sessions and moderate intensity, depression chronic post-stroke
64–76% of maximum Hamilton Depression phase.
N= 4, completed only heart rate), once each Rating Scale (HAM-D)
one session week for 2 consecutive Measure of fatigue
Aerobic exercise in the weeks. Fatigue Severity Scale
form of a walk (FSS)
T0: Baseline Measure of functional
T1: After 2 weeks capacity
6MWT
Measure of functional
dependence
Modified Rankin Scale
Measure of brain
neural plasticity
Serum BDNF analysis
using ELISA

8 dropouts were
reported

Cichon N et al RCT 48 sub acute stroke Out patient training CG: 105 minutes per Measure of severity ELF-EMG intervention
(2018) 39 United States Of with post stroke period session for 10 sessions NIHSS shows an increase in
America of at at least 6 months CG: N= 23 with an interval of 14 Measure of functional the serum BDNF
Simple Randomisation and subjects with the Conventional days recovery levels which enhances
mean age of therapeutic program of BI for ADL functional recovery in
CG: 44.8 + 7.7 an aerobic exercise 30 IG: 120 minutes per Measure of cognition post stroke subjects.
IG: 48.0 + 8.0 min, session for 10 sessions Mini Mental State
neurophysiological with an interval of 14 Examination
routines 60 min, and 15 days. Measure of functional
min psychological dependence
therapy. T0: Baseline Modified Rankin Scale
T1: After 10 sessions Measure of brain
IG: N= 25 neural plasticity
Same therapy as the Serum BDNF analysis
CG followed by ELF- using ELISA
EMF therapy for 15 No dropouts
 minutes. ELF-EMF
therapy- magnetic
induction of 5 mT, 40
Hz, rectangular and
bipolar waveforms

Boyne P, et al Patient Cohort Trial 16 chronic stroke with Out patient based Each protocol had a 3- Measure of peak Vigorous aerobic
(2018) 40 Unite States Of post stroke period of > training min warm up at 30– oxygen consumption intensity (Treadmill
America 6 months and subjects N= 16 50% heart rate reserve VO2peak and heart high-intensity interval
No Randomisation with the mean age of Single sessions of three (HRR), 20 min of rate (HRpeak) training) showed an
57.4 + 9.7 different exercise exercise, and a 2-min acute increase in
protocols- cool down. Measure of brain circulating BDNF
Treadmill high- T0: before the warm up neural plasticity which enhances
intensity interval T5, T10, and T20: Serum BDNF analysis learning post stroke.
training after 5, 10, and 20 min using ELISA
Seated stepper high- of exercise
intensity interval T50 and T80: 30 and No dropouts
training 60 min after finishing
Treadmill moderate- the exercise
intensity continuous
exercise

They were in random

order with 1 week
between sessions

Chang WC Patient Cohort Trial 45 subacute stroke with In patient based 2 hrs of physical Measure of Exercise training
(2018) 41 Korea post stroke period of training therapy daily and 1 h of depression showed improvements
No Randomisation <1 month and patients N= 38 occupational therapy 5 Geriatric Depression in the depressive mood
with the mean age of Standard rehabilitation days a week for a Scale-Short Form of the subjects and
62.9 ± 14.6 program- Physical period of 2 weeks. (GDS-SF) correlated with serum
therapy and BDNF and can be used
occupational therapy TO: Baseline Measure of brain as a biomarker for
T1: 1 week after the neural plasticity depressive mood in
standard rehabilitation Serum BDNF analysis subacute stroke
program using ELISA subjects
T2: 2 weeks after the
standard rehabilitation 7 subjects dropped out
 program

Chaturvedi P et al RCT 90 subacute stroke with Out patient based CG: 30 minutes twice Measure of motor PNF exercises proved
(2018) 42 India post stroke period of < training daily for 5 days a week. recovery to be effecient to
Simple Randomisation 6 weeks and subjects CG: N= 49 Followed up on a Fugl Mayers assesment improve the brain
with mean age for Conventional physical monthly basis for 6 neural plasticity as
CG: 55.29 + 15.9 therapy program months. Measure of motor compared to the
IG: 61.3+ 13.3 function of upper standard exercise
IG: N= 41 IG: 30 minutes twice extremity training program.
PNF exercises daily for 5 days a week Arm Motor Ability
for 4 weeks
Measure of brain
T0: Baseline neural plasticity
Serum BDNF analysis
using ELISA
T1: After 4 weeks
No dropouts

King M et al Patient Cohort Trial 35 chronic stroke with Out patient training Mean duration- 12 Measure of brain Serum BDNF showed
(2019) 43 Canada post stroke period of > program minutes 46 sec +6 min neural plasticity an increase post
No Randomisation 6 months and subjects N= 35 4 sec Participant mean Serum BDNF analysis maximal exercise test
with the mean age of A single session of VO2max- 17.0 + 4.66 ml using ELISA in chronic stroke
65.2 ± 9.4 maximal aerobic of O2/ min/kg. subjects
exercise test performed No dropouts
on either a body weight Recumbent stepper: N=
sup- ported treadmill or 13
on a total body Treadmill test: N=22
recumbent stepper
based on a standard
exercise protocol. T0: At baseline
T1: After exercise test

Hsu CC et al RCT 23 chronic stroke In hospital supervision Both the groups were Measure of peak HIIT was associated
(2020) 44 Taiwan subjects with post based training delivered with a oxygen consumption with a greater increase
 stroke period of > 24 MICT: N= 13 training of 30 minutes VO2peak in the serum BDNF
A computer-generated, months and mean age On bicycle ergometer per session for 36 levels as compared to
concealed allocation of 58.5 years and 53.1 at 60% VO2peak sessions for three Measure of brain the MICT.
schedule was used to year in the High months. neural plasticity
randomly allocate Intensity Interval HIIT: N= 10 T0: Baseline Serum BDNF analysis
participants Training(HIIT) and On bicycle ergometer T1: After completion of using ELISA
Moderate Intensity at 80% VO2peak for 30 36 sessions.
Continuous minutes followed by a 1 dropout was recorded
training(MICT) cool down at 30 % from the group which
program respectively VO2peak for 3 minutes. was given the HIIT
training.
Increase by 20% in the
HRreserve as per the
patient’s tolerance.