Optimizing physical fitness in chronic stroke patients: the impact of exercise training modality and dosage on maximal and sub-maximal fitness - a systematic review and meta-analysis.

IF 2.3 4区 医学 Q1 REHABILITATION
Felix Nindorera, Clement Leveque, Eric Meyer, Costantino Balestra, Sigrid Theunissen
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引用次数: 0

Abstract

Objective: To evaluate the effects of different exercise training modalities on maximal and sub-maximal physical fitness in chronic stroke patients and determine the optimal training dosage.

Design: Systematic review and meta-analysis of 38 randomized controlled trials.

Methods:  A comprehensive search was conducted across seven databases (MedLine, Embase, ScienceDirect, Cochrane Library, CINAHL, and SPORTSDiscus) up to March 31, 2024. Maximal fitness was measured by VO2 max/peak, and sub-maximal fitness by the 6- or 12-minute walk test (6MWT) Results: Aerobic and mixed training significantly improved VO2 max/peak (MD = 3.16 [2.83, 3.49], p < 0.00001; I² = 22%). Only aerobic training significantly enhanced 6MWT performance (MD = 34.30 [25.08, 43.53], p < 0.00001; I² = 25%). Sensitivity analysis revealed that VO2 max/peak gains were greater with moderate-to-high intensity, while moderate intensity sufficed for 6MWT improvement. The optimal regimen was 45-minute sessions of moderate-to-high intensity aerobic training, at least three times weekly for a minimum of eight weeks.

Conclusion:  Moderate-to-vigorous aerobic training enhances physical fitness in chronic stroke. High-intensity and mixed training programs yield greater maximal fitness improvements, while moderate intensity benefits sub-maximal capacity. Targeted, intensity-monitored exercise programs of ≥45 minutes, three times weekly over ≥8 weeks, are recommended for significant fitness gains.

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优化慢性脑卒中患者体能:运动训练方式和剂量对最大和次最大体能的影响——一项系统综述和荟萃分析
目的:评价不同运动训练方式对慢性脑卒中患者最大、次最大体能的影响,确定最佳训练剂量。设计:对38项随机对照试验进行系统评价和荟萃分析。方法:对截至2024年3月31日的7个数据库(MedLine、Embase、ScienceDirect、Cochrane Library、CINAHL和SPORTSDiscus)进行全面检索。结果:有氧和混合训练显著提高了VO2 max/peak (MD = 3.16 [2.83, 3.49], p < 0.00001;I²= 22%)。仅有氧训练可显著提高6MWT表现(MD = 34.30 [25.08, 43.53], p < 0.00001;I²= 25%)。敏感性分析显示,中至高强度的VO2 max/peak增益更大,而中等强度足以提高6MWT。最佳方案是每次45分钟的中等到高强度有氧训练,每周至少三次,持续至少八周。结论:中高强度有氧训练可提高慢性脑卒中患者的体质。高强度和混合训练计划产生更大的最大体能改善,而中等强度有利于次最大能力。有针对性的、强度监测的≥45分钟的锻炼计划,每周3次,持续≥8周,可以获得显著的健身效果。
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来源期刊
CiteScore
5.60
自引率
5.70%
发文量
102
审稿时长
4-8 weeks
期刊介绍: Journal of Rehabilitation Medicine is an international peer-review journal published in English, with at least 10 issues published per year. Original articles, reviews, case reports, short communications, special reports and letters to the editor are published, as also are editorials and book reviews. The journal strives to provide its readers with a variety of topics, including: functional assessment and intervention studies, clinical studies in various patient groups, methodology in physical and rehabilitation medicine, epidemiological studies on disabling conditions and reports on vocational and sociomedical aspects of rehabilitation.
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