Physical fitness training for stroke patients

Area of Science:

• Neurology
• Rehabilitation Medicine
• Exercise Science

Background:

• Physical activity and fitness levels are often reduced post-stroke.
• Interventions aimed at improving physical fitness may decrease mortality and disability by enhancing function.

Purpose of the Study:

• To evaluate the effectiveness of fitness training in reducing death, death or dependence, and disability in stroke survivors.
• To assess the impact of training on adverse events, risk factors, physical fitness, mobility, physical function, mood, and quality of life.

Main Methods:

• A systematic review and meta-analysis of 75 randomized controlled trials involving 3017 participants.
• Included interventions were cardiorespiratory, resistance, or mixed training compared to usual care or no intervention.
• Data were analyzed using random-effects meta-analyses, with evidence quality assessed by the GRADE approach.

Main Results:

• Cardiorespiratory and mixed training significantly improved disability scores (moderate to low certainty evidence).
• Multiple benefits were observed in physical fitness (VO2 peak, strength), mobility (walking speed), and physical function (balance).
• No serious adverse events were reported; cardiorespiratory training increased cardiorespiratory fitness (VO2 peak).

Conclusions:

• Cardiorespiratory and mixed training are effective in reducing disability post-stroke, likely through improved mobility and balance.
• Evidence supports incorporating these training types into rehabilitation to enhance fitness, balance, and walking.
• Further research is needed to optimize exercise prescription and explore long-term benefits, particularly for cognitive function.