Felix Nindorera, Clement Leveque, Eric Meyer, Costantino Balestra, Sigrid Theunissen
{"title":"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","authors":"Felix Nindorera, Clement Leveque, Eric Meyer, Costantino Balestra, Sigrid Theunissen","doi":"10.2340/jrm.v57.43359","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Design: </strong>Systematic review and meta-analysis of 38 randomized controlled trials.</p><p><strong>Methods: </strong> 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.</p><p><strong>Conclusion: </strong> 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.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm43359"},"PeriodicalIF":2.3000,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359817/pdf/","citationCount":"0","resultStr":"{\"title\":\"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.\",\"authors\":\"Felix Nindorera, Clement Leveque, Eric Meyer, Costantino Balestra, Sigrid Theunissen\",\"doi\":\"10.2340/jrm.v57.43359\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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.</p><p><strong>Design: </strong>Systematic review and meta-analysis of 38 randomized controlled trials.</p><p><strong>Methods: </strong> 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.</p><p><strong>Conclusion: </strong> 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.</p>\",\"PeriodicalId\":54768,\"journal\":{\"name\":\"Journal of Rehabilitation Medicine\",\"volume\":\"57 \",\"pages\":\"jrm43359\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-08-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359817/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Rehabilitation Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2340/jrm.v57.43359\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Rehabilitation Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2340/jrm.v57.43359","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
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.
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.
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.