Optimal exercise modalities for enhancing motor function recovery after stroke: a Bayesian systematic review with...

Area of Science:

• Neurorehabilitation
• Clinical Exercise Physiology
• Evidence-Based Medicine

Background:

• Stroke significantly impairs motor function, necessitating effective rehabilitation strategies.
• Optimizing exercise interventions is crucial for enhancing motor recovery after stroke.

Purpose of the Study:

• To compare the efficacy of diverse exercise interventions for post-stroke motor function recovery.
• To identify optimal rehabilitation strategies based on comparative effectiveness.

Main Methods:

• Systematic review and Bayesian network meta-analysis of 317 randomized controlled trials (RCTs) involving 14,464 stroke patients.
• Primary outcomes included walking tests (6MWT, 10MWT), balance (BBS), and Fugl-Meyer Assessment (FMA).
• Risk of bias and evidence certainty were assessed using RoB 2 and CINeMA tools, respectively.

Main Results:

• Electrical stimulation plus exercise (ESX) yielded the greatest improvement in walking endurance.
• Lower limb training (LLT) demonstrated the largest gains in gait speed.
• Core stability training (CST) and functional training (FT) showed the most significant improvements in balance and overall motor function (FMA), respectively.

Conclusions:

• Structured exercise interventions, including ESX, LLT, CST, and FT, are associated with improved motor outcomes post-stroke.
• Meta-regression identified factors like intervention duration and stroke phase influencing outcomes, though heterogeneity was noted.
• Findings suggest tailored exercise approaches can enhance stroke motor recovery, but results require cautious interpretation due to observed variability.