Abstract
Objective
To determine if prescribing a combined aerobic and resistance training exercise program
in accordance with American Stroke Association physical activity guidelines improves
mobility and physical activity levels of people after stroke.
Data Sources
Online database search from earliest available date to August 27, 2018.
Study Selection
Randomized controlled trials evaluating the effectiveness of exercise programs prescribed
in accordance with guidelines for improving mobility and physical activity levels
in adults with subacute or chronic stroke.
Data Extraction
Two independent reviewers completed data extraction. Risk of bias was assessed using
the Physiotherapy Evidence Database Scale, and overall quality of evidence was assessed
using the Grades of Research, Assessment, Development, and Evaluation approach.
Data Synthesis
Data was pooled from a total of 499 participants for meta-analysis. There was high-level
evidence that exercise programs adhering to guidelines improve habitual walking speed
(mean difference, 0.07m/s; 95% CI, −0.01 to 0.16) and walking endurance (mean difference,
39.2m, 95% CI, 17.2-61.2). A sensitivity analysis demonstrated high-level evidence
of improvements in walking endurance (mean difference, 51.1m; 95% CI, 19.96-82.24)
and moderate-level evidence of improvements on the Timed Up and Go test (standardized
mean difference, 0.57; 95% CI, 0.16-0.99). No differences were detected for other
mobility outcome measures or physical activity levels. Adherence was high and few
adverse events were reported.
Conclusion
A combined exercise program comprising aerobic and resistance training that adheres
to the American Stroke Association guidelines is safe and should be prescribed in
addition to usual care to improve mobility. Further research is needed to understand
the relationship between exercise programs and behavior change requirements to improve
long-term physical activity levels.
Keywords
List of abbreviations:
ASA (American Stroke Association), FITT (frequency, intensity, time, and type), MD (mean difference), PEDro (Physiotherapy Evidence Database), SMD (standardized mean difference)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 08, 2019
Footnotes
Disclosures: none.
Clinical Trial Registration No.: CRD42018109506.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
