Physical Fitness Training for Stroke Patients
2004; Lippincott Williams & Wilkins; Volume: 35; Issue: 9 Linguagem: Inglês
10.1161/01.str.0000137413.94706.ba
ISSN1524-4628
AutoresDavid H. Saunders, Carolyn Greig, Archie Young, Gillian Mead,
Tópico(s)Acute Ischemic Stroke Management
ResumoHomeStrokeVol. 35, No. 9Physical Fitness Training for Stroke Patients Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessReview ArticlePDF/EPUBPhysical Fitness Training for Stroke Patients David H. Saunders, BSc, MPhil, Carolyn A. Greig, BSc, MSc, PhD, Archie Young, BSc, MBChB, MD, FRCP and Gillian E. Mead, MB, BChir, FRCP, MD, MA David H. SaundersDavid H. Saunders From the Department of Physical Education Sport and Leisure Studies (D.H.S.), and Geriatric Medicine (C.A.G., A.Y., G.E.M.), Department of Clinical and Surgical Sciences, The University of Edinburgh, UK. , Carolyn A. GreigCarolyn A. Greig From the Department of Physical Education Sport and Leisure Studies (D.H.S.), and Geriatric Medicine (C.A.G., A.Y., G.E.M.), Department of Clinical and Surgical Sciences, The University of Edinburgh, UK. , Archie YoungArchie Young From the Department of Physical Education Sport and Leisure Studies (D.H.S.), and Geriatric Medicine (C.A.G., A.Y., G.E.M.), Department of Clinical and Surgical Sciences, The University of Edinburgh, UK. and Gillian E. MeadGillian E. Mead From the Department of Physical Education Sport and Leisure Studies (D.H.S.), and Geriatric Medicine (C.A.G., A.Y., G.E.M.), Department of Clinical and Surgical Sciences, The University of Edinburgh, UK. Originally published15 Jul 2004https://doi.org/10.1161/01.STR.0000137413.94706.baStroke. 2004;35:2235Other version(s) of this articleYou are viewing the most recent version of this article. Previous versions: July 15, 2004: Previous Version 1 Physical fitness is important for the performance of everyday activities. Although muscle strength and cardiorespiratory fitness are impaired in stroke patients, it is not known whether improving fitness by physical fitness training reduces disability after stroke.ObjectivesThe objective of this study was to perform a systematic review to establish whether strength and/or cardiorespiratory fitness training reduces death, dependence, and disability after stroke. Secondary aims were to evaluate the effects of fitness training on physical fitness, mobility, physical function, health and quality of life, mood, and the incidence of adverse events.MethodsSearch StrategyWe searched the Cochrane Stroke Group Trials Register (last searched June 2003). In addition, the following electronic databases were searched: Cochrane Central Register of Controlled Trials (Cochrane Library, Issue 4, 2002), MEDLINE (1966 to December 2002), EMBASE (1980 to December 2002), CINAHL (1982 to December 2002), SPORTDiscus (1949 to December 2002), Science Citation Index Expanded (1981 to December 2002), Web of Science Proceedings (1982 to December 2002), PEDro (December 2002), REHABDATA (1956 to December 2002), and Index to UK Theses (1970 to December 2002). We hand-searched relevant journals and conference proceedings and screened reference lists. To identify unpublished and ongoing trials, we searched trial directories and contacted experts in the field.Selection CriteriaRandomized controlled trials were included when an intervention represented a clear attempt to improve muscle strength and/or cardiorespiratory fitness, and whose control groups comprised either usual care or a non-exercise intervention.Data Collection and AnalysisData from eligible studies were independently extracted by 2 reviewers. The primary outcome measures were death, disability, and dependence. Standardized mean differences (SMD) and weighted mean differences (WMD) of variables were calculated using fixed and random effects models, but lack of common outcome measures limited the analysis.ResultsTwelve trials comprising 289 participants met the inclusion criteria. Only 3 trials commenced soon (<1 month) after stroke, and only 2 examined the effect of strength training. No trials reported death and dependence data. Two small trials reporting disability showed no evidence of benefit (SMD, −0.06; 95% CI, −0.76 to 0.65). There were few secondary outcome measures common to the included trials. Significant improvements were observed only in Functional Ambulation Category scores (WMD, 0.60; 95% CI, 0.14 to 1.06) and maximal walking speed (SMD, 0.42 m/s; 95% CI, 0.04 to 0.79) after cardiorespiratory walking training. Like ambulation outcomes, the incidence of other physical benefits was associated with interventions using modes of physical activity closely related to the outcome task.Reviewer ConclusionsThere are inadequate data to either encourage or discourage physical fitness training after stroke. Beyond improvements in some measures of ambulation, little is known about the benefits of fitness training in stroke patients or the optimal regimen for improving fitness. Any training-induced functional benefits appear to be associated with specific or "task-related" training.Fitness training after stroke is an under-researched area. Further trials are needed to determine the efficacy and feasibility of fitness training, particularly soon after stroke. The optimal training regimen for improving fitness remains unknown; therefore, smaller more specific studies are also required. These should explore the effect of "dose" and type of training, particularly strength training.Note: The full text of this review is available in The Cochrane Library (for subscribers: www.update-software.com/Cochrane). The full article should be cited as: Saunders DH, Greig CA, Young A, Mead GE. Physical fitness training for stroke patients (Cochrane Review). In: The Cochrane Library. Issue 1, 2004. Oxford, UK: Update Software, © Cochrane Library, John Wiley & Sons, Ltd.Section Editor: Graeme J. Hankey MD, FRACPFootnotesCorrespondence to David H. Saunders, Department of Physical Education Sport and Leisure Studies, The University of Edinburgh, Holyrood Road, Edinburgh, EH8 8AQ, UK. E-mail [email protected] Previous Back to top Next FiguresReferencesRelatedDetailsCited By Tuntevski K, Hajira A, Nichols A, Alway S and Mohamed J (2020) Muscle‐specific sirtuin1 gain‐of‐function ameliorates skeletal muscle atrophy in a pre‐clinical mouse model of cerebral ischemic stroke, FASEB BioAdvances, 10.1096/fba.2020-00017, 2:7, (387-397), Online publication date: 1-Jul-2020. 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Saunders D, Sanderson M, Hayes S, Johnson L, Kramer S, Carter D, Jarvis H, Brazzelli M and Mead G (2020) Physical fitness training for stroke patients, Cochrane Database of Systematic Reviews, 10.1002/14651858.CD003316.pub7, 2020:3 Saunders D, Greig C, Mead G, Young A and Saunders D (2009) Physical fitness training for stroke patients Cochrane Database of Systematic Reviews, 10.1002/14651858.CD003316.pub3 Saunders D, Sanderson M, Hayes S, Kilrane M, Greig C, Brazzelli M and Mead G (2016) Physical fitness training for stroke patients, Cochrane Database of Systematic Reviews, 10.1002/14651858.CD003316.pub6 Ferrandi P, Khan M, Paez H, Pitzer C, Alway S and Mohamed J (2020) Transcriptome Analysis of Skeletal Muscle Reveals Altered Proteolytic and Neuromuscular Junction Associated Gene Expressions in a Mouse Model of Cerebral Ischemic Stroke, Genes, 10.3390/genes11070726, 11:7, (726) Brazzelli M, Saunders D, Greig C, Mead G and Saunders D (2011) Physical fitness training for stroke patients Cochrane Database of Systematic Reviews, 10.1002/14651858.CD003316.pub4 Saunders D, Sanderson M, Brazzelli M, Greig C, Mead G and Saunders D (2013) Physical fitness training for stroke patients Cochrane Database of Systematic Reviews, 10.1002/14651858.CD003316.pub5 September 2004Vol 35, Issue 9 Advertisement Article InformationMetrics https://doi.org/10.1161/01.STR.0000137413.94706.baPMID: 15256681 Manuscript receivedJanuary 13, 2004Manuscript acceptedFebruary 12, 2004Originally publishedJuly 15, 2004 PDF download Advertisement
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