Oxygen Consumption and Metabolic Equivalents During Physical Activities in Stroke: A Systematic Review.

Background and purpose: Patient education on physical activity (PA) requires a clear understanding of PA intensity. However, there is no organized list of PAs intensities specific to individuals with stroke. This review aimed to clarify the intensity of PAs in people with stroke and summarize the methodologies and participant characteristics in previous investigations of energy expenditure (EE) during PAs.

Methods: A systematic search was conducted using PubMed, CINAHL, the Cochrane Library, and PEDro databases in October 2021, and repeated in February 2024. Reports meeting the eligibility criteria were reviewed to extract participant characteristics and summarized EE for each PA type according to gait ability. Where possible, EE during PA was integrated using a weighted mean.

Results: A total of 55 eligible articles and 1719 participants were included. Twenty-one PAs were identified, most of which involved walking or exercise. Data on acute stroke were sparse, accounting for only 1.2% of all participants. PAs related to daily living were typically measured over 5-8 min, with steady-state means used for movement tasks. Among ambulatory patients, walking with maximal effort corresponded to moderate-to-vigorous PA (> 3 METs), even at low speeds. However, comfortable walking at slow speeds, sit-to-stand, and reaching while standing corresponded to light PA (1.6-2.9 METs).

Discussion: EE during PA in people with stroke has been inadequately investigated, particularly for daily activities other than walking, and studies involving acute stroke remain limited. Additionally, EE during light PAs, such as reaching, sit-to-stand, wheelchair propulsion, and comfortable walking at slow speed in ambulatory stroke patients, was found to align closely with values reported in the Compendium of PAs.

Trial registration: PROSPERO, CRD42022300366.