[Abstract] Factors Influencing the Efficacy of Aerobic Exercise for Improving Fitness and Walking Capacity After Stroke: A Meta-Analysis with Meta-Regression.

Abstract

Objective

To assess the influence of dosing parameters and patient characteristics on the efficacy of aerobic exercise (AEX) post-stroke.

Data Sources

A systematic review was conducted using Pubmed, MEDLINE, CINAHL, PEDro and Academic Search Complete.

Study Selection

Studies were selected that compared AEX to a non-aerobic control group among ambulatory persons with stroke.

Data Extraction

Extracted outcome data included: peak oxygen consumption during exercise testing (VO2peak), walking speed and walking endurance (6-minute walk test). Independent variables of interest were: AEX mode (seated or walking), AEX intensity (moderate or vigorous), AEX volume (total hours), stroke chronicity and baseline outcome scores.

Data Synthesis

Significant between-study heterogeneity was confirmed for all outcomes. Pooled AEX effect size estimates (AEX change – control change) from random effects models were: VO2peak, 2.2 mL/kg/min [95% CI: 1.3, 3.1]; walking speed, 0.06 m/s [95% CI: 0.01, 0.11]; and 6-minute walk test distance, 29 m [95% CI: 15, 42]. From meta-regression, greater VO2peak effect sizes were significantly associated with higher AEX intensity and higher baseline VO2peak. Greater effect sizes for walking speed and the 6-minute walk test were significantly associated with a walking AEX mode. In contrast, seated AEX did not have a significant effect on walking outcomes.

Conclusions

AEX significantly improves aerobic capacity post-stroke, but may need to be task specific to impact walking speed and endurance. Higher AEX intensity is associated with better outcomes. Future randomized studies are needed to confirm these results.

Source: Factors Influencing the Efficacy of Aerobic Exercise for Improving Fitness and Walking Capacity After Stroke: A Meta-Analysis with Meta-Regression – Archives of Physical Medicine and Rehabilitation

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