Rapid Improvement of Constipation Following Aerobic Exercise in a Patient with Stroke: A Case Report

Abstract

Constipation is a common but often overlooked issue among stroke survivors, despite its adverse impact on recovery. Herein, we describe an unexpected improvement in constipation following aerobic exercise during the rehabilitation of a patient in the subacute stage of stroke. A man in his 70 s with moderate right-sided hemiparesis following a pontine infarction was admitted for inpatient rehabilitation. Despite maintaining a stable diet and fluid intake, as well as regular use of laxatives, he experienced persistent constipation (one to three bowel movements per week). After 4 weeks of standard rehabilitation, an aerobic exercise regimen was introduced, comprising 30-min sessions on a recumbent ergometer performed five times per week at 50% of the heart rate reserve. No changes were made to his medication, diet, or other therapies during the aerobic exercise period. After initiating aerobic exercise, the patient's bowel movement frequency increased rapidly to four to six times per week, with a marked reduction in constipation symptoms evident from the first week of intervention. To evaluate the effectiveness of aerobic exercise, the percentage of non-overlapping data (PND) was calculated. The PND was 75%, indicating that the intervention was effective. This improvement was sustained both during and after the aerobic exercise period. No other potential confounding factors were identified. This case highlights a temporal association between moderateintensity aerobic exercise and improved constipation in a patient with stroke, suggesting that exercise may warrant investigation as a potential adjunctive intervention. However, the retrospective, single-case design precludes causal inference, and the observed improvements could reflect natural variation or unmeasured confounders. A plausible mechanistic