Background: Cardiorespiratory fitness (CRF) is commonly reduced in people following a stroke and multiple guidelines recommend individualised cardiorespiratory (CR) intervention to address this impairment. However there is limited understanding on how to implement CR training, particularly within the first six months following stroke, or in people requiring assistance to ambulate.
Objectives: To explore perspectives of Australian Physiotherapists and Exercise Physiologists to understand how CR interventions are implemented to address CRF in sub-acute stroke, including enablers, barriers and the clinical reasoning process undertaken.
Methods: A mixed-methods study was undertaken between April-December 2025. Australian Physiotherapists and Exercise Physiologists were invited to participate in an online survey and/or semi-structured interviews. Survey responses were analysed in SPSS. Semi-structured interviews were transcribed and three researchers used inductive and deductive coding with thematic analysis to identify common themes.
Results: A total of 53 Physiotherapists or Exercise Physiologists completed the online survey and 10 Physiotherapists participated in semi-structured interviews. Assessment of CRF mostly required some form of equipment using sub-maximal tests and symptom monitoring. Seventeen different types of intervention were identified to address CRF, mostly applied at moderate intensity and at least three times weekly. Qualitative themes identified: common influences of clinicians intervention; clinicians report a highly varied approach to addressing CRF; aquatic therapy is a type of intervention used for addressing CRF; and clinicians are seeking more evidence-based recommendations for aquatic therapy.
Conclusion: Highly varied approaches are undertaken to address CRF in sub-acute stroke and clinicians are seeking more specific evidence to support clinical practice.