Effect of Community Exercise for Patients with Stroke: A Systematic Review and Meta-analysis

Abstract

Background Community exercise might be beneficial to stroke recovery. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the effect of community exercise on stroke patients. Methods PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of community exercise vs. usual care on stroke were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome were 6-Minute walk test and walking speed. Metaanalysis was performed using random-effect model. Results Four RCTs involving 497 patients were included in the metaanalysis. Overall, compared with control intervention, community exercise intervention was found to significantly improve 6-Minute walk distance (Std. mean difference=0.48; 95% CI=0.22 to 0.74; P=0.0003), and walking speed (Std. mean difference=0.40; 95% CI=0.10 to 0.70; P=0.009) in stroke patients, but resulted in no influence on Berg Balance Scale (Std. mean difference=0.39; 95% CI=−0.29 to 1.07; P=0.26), muscle strength (Std. mean difference=0.05; 95% CI=-0.34 to 0.43; P=0.82) and mental quality of life (Std. mean difference=0.04; 95% CI=−0.25 to 0.34; P=0.77). Conclusions Compared to control intervention, community exercise was found to significantly increase 6-Minute walk test, walking speed and Berg Balance Scale, but showed no influence on Berg Balance Scale, muscle strength and mental quality of life.

Agreement, Reliability, and Concurrent Validity of an Outdoor, Wearable-Based Walk Ratio Assessment in Healthy Adults and Chronic Stroke Survivors

“…Approximately fifty percent of people surviving a stroke recover so far that they retain only minor consequences from the stroke ( FragileSuisse, 2022 ). Such moderate to high functioning stroke survivors may have regained gait ability and speed to be able to ambulate without walking aid and in the community ( Faria-Fortini et al, 2019 ; Peng et al, 2020 ; Vive et al, 2021 ), however, still show impaired gait control ( Guzik et al, 2017 ). For measuring gait control in these individuals, the WR may be a helpful parameter, as it adds valuable information regarding gait quality to clinical gait assessments such as gait speed ( Bogen et al, 2018 ).…”

Cognitive and Linguistic Benefits of Aerobic Exercise: A State-of-the-Art Systematic Review of the Stroke Literature

“…It follows that aerobic exercise would benefit cognitive functioning following stroke; accordingly, recent systematic reviews have concluded that aerobic exercise may enhance cognition in the stroke population [e.g., (30)(31)(32)(33)(34)(35)(36)]. However, 1 For the purposes of this paper, we will use the following definitions for physical activity, exercise, aerobic exercise, and strength/resistance training.…”

“…Related to the limited examination of language abilities as a cognitive domain that may be responsive to exercise, there is a concern as to whether stroke survivors with aphasia have been represented in the extant literature. For example, the word "aphasia" was absent in previous systematic reviews of exercise and cognition post-stroke, [e.g., (35)(36)(37)]. This is surprising, given that approximately one-third of stroke survivors are living with aphasia (38,39) and experience changes with both language and other cognitive abilities (40).…”