Monday, October 17, 2016

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

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

Arch Phys Med Rehabil. 2016 Oct 12;:

Authors: Boyne P, Welge J, Kissela B, Dunning K


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.

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