Optimal exercise modalities for post-intervention motor function changes in stroke survivors: a pairwise and network...

Area of Science:

• Neurology
• Rehabilitation Medicine
• Geriatrics

Background:

• Stroke is a primary cause of long-term disability in older adults, impacting independence and quality of life.
• Exercise interventions promote motor recovery, but long-term benefits during follow-up periods are poorly understood.
• Understanding functional trajectories post-rehabilitation is crucial for assessing the value of interventions.

Purpose of the Study:

• To systematically evaluate motor function outcomes in post-stroke adults during follow-up periods.
• To compare the effectiveness of various exercise modalities for long-term stroke recovery.
• To inform the design of rehabilitation programs prioritizing sustained functional gains.

Main Methods:

• Systematic review and network meta-analysis following PRISMA 2020 guidelines.
• Searched five databases for randomized controlled trials up to March 13, 2025.
• Assessed risk of bias using RoB 2.0 and evidence quality via CINeMA; conducted pairwise and Bayesian network meta-analyses.

Main Results:

• Included 64 trials (3074 participants) covering 23 exercise modalities.
• Resistance training and robot-assisted therapy showed the greatest effects on walking capacity (6-min walk test).
• Task-oriented training significantly improved balance, but upper/lower limb outcomes were inconclusive.

Conclusions:

• Resistance training and robot-assisted therapy are most effective for enhancing post-stroke walking capacity.
• Task-oriented training demonstrates benefits for postural balance.
• Further research is needed for upper and lower limb recovery due to limited evidence.