Muscle as an Endocrine Organ in Stroke Rehabilitation: Aerobic Exercise–Driven Myokine Responses and Functional Gains

Background In recent years, the role of myokines released from muscles in response to exercise in supporting neuroplasticity and recovery has attracted increasing attention within the scientific community. Among these, irisin, myonectin, brain-derived neurotrophic factor (BDNF) and interleukin-15 (IL-15) are particularly associated with neuromuscular health, energy metabolism and neurogenesis. This study aimed to investigate the effects of a structured aerobic exercise programme on serum levels of selected myokines and functional recovery in post-stroke patients. Methods Patients with ischaemic stroke were prospectively allocated according to rehabilitation modality into two comparative exercise settings over a 6-week period: a supervised bicycle-based aerobic exercise programme (n = 41) and a self-directed home exercise programme (n = 40). In biochemical assessments, serum irisin, myonectin, BDNF and IL-15 levels were measured using the ELISA method. Physical assessment tools included the Fatigue Severity Scale Test (FSS Test), the 30-Second Sit-to-Stand Test (30s-STS), the 6-minute walk test (6MWT) and the Borg perceived exertion scale (RPE). Results The aerobic exercise group demonstrated statistically significant changes (p < 0.001) in serum myonectin, BDNF, irisin and IL-15 levels following the intervention. These changes were accompanied by marked improvements in balance and walking capacity. In contrast, the home exercise group showed only marginal or non-significant changes in both biochemical and functional outcomes. Conclusion Aerobic exercise influences serum myokine profiles in post-stroke patients, and these changes are associated with improvements in physical function. This study demonstrates that integrating exercise programmes conducted under professional supervision into stroke rehabilitation may provide significant benefits at both the molecular and functional levels.