Abstract
Objective
To assess the influence of dosing parameters and patient characteristics on the efficacy
of aerobic exercise (AEX) poststroke.
Data Sources
A systematic review was conducted using PubMed, MEDLINE, Cumulative Index of Nursing
and Allied Health Literature, Physiotherapy Evidence Database, and Academic Search
Complete.
Study Selection
Studies were selected that compared an AEX group with a nonaerobic control group among
ambulatory persons with stroke.
Data Extraction
Extracted outcome data included peak oxygen consumption (o2peak) during exercise testing, walking speed, and walking endurance (6-min 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 group change minus control group change) from random effects
models were o2peak, 2.2mL⋅kg−1⋅min−1 (95% confidence interval [CI], 1.3–3.1mL⋅kg−1⋅min−1); walking speed, .06m/s (95% CI, .01–.11m/s); and 6-minute walk test distance, 29m
(95% CI, 15–42m). In meta-regression, larger o2peak effect sizes were significantly associated with higher AEX intensity and higher
baseline o2peak. Larger 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 poststroke, but may need to be task specific
to affect walking speed and endurance. Higher AEX intensity is associated with better
outcomes. Future randomized studies are needed to confirm these results.
Keywords
List of abbreviations:
AEX (aerobic exercise), CI (confidence interval), HRmax (maximal heart rate), HRR (heart rate reserve), PEDro (Physiotherapy Evidence Database), V˙o2peak (peak oxygen consumption)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 13, 2016
Footnotes
Conducted in partial fulfillment of the requirements for a PhD in Epidemiology (P.B.) in the Department of Environmental Health at the University of Cincinnati College of Medicine.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
