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.

Zusammenfassung

Hintergrund Sport in der Gruppe kann sich positiv auf den Heilungsverlauf nach einem Schlaganfall auswirken. Die Ergebnisse sind jedoch umstritten. Wir haben eine systematische Literaturrecherche und Meta-Analyse durchgeführt, um die Wirkung von Sport in der Gruppe bei Schlaganfallpatienten zu untersuchen.

Methoden Es wurde eine systematische Literaturrecherche in PubMed, EMbase, Web of science, EBSCO und der Cochrane library Datenbank durchgeführt. Darin eingeschlossen waren randomisierte Studien (RCTs), in der die Wirkung von Sport in der Gruppe vs. herkömmliche Maßnahmen bei Schlaganfallpatienten untersucht wurde. Zwei Untersucher recherchierten unabhängig voneinander Artikel, extrahierten Daten und bewerteten die Qualität der eingeschlossenen Studien. Primäre Zielgrößen waren der 6-Minuten-Gehtest und Gehgeschwindigkeit. Die Meta-Analyse wurde mithilfe von Datenmodellen mit zufälligen Effekten durchgeführt.

Ergebnisse In der Meta-Analyse wurden 4 RCTs untersucht, an denen 497 Patienten teilgenommen hatten. Insgesamt konnte festgestellt werden, dass Sport in der Gruppe im Vergleich zu herkömmlichen Maßnahmen die Distanz beim 6-Minuten-Gehtest bei Schlaganfallpatienten signifikant verbesserte (Standardabweichung mittlere Differenz=0,48; 95% CI=0,22– 0,74; P=0,0003), ebenso die Gehgeschwindigkeit (Standardabweichung mittlere Differenz=0,40; 95% CI=0,10–0,70; P=0,009), jedoch konnte kein Unterschied bei der Berg-Balance-Skala (Standardabweichung mittlere Differenz=0,39; 95% CI=−0,29 bis 1,07; P=0,26), der Muskelkraft (Standardabweichung mittlere Differenz=0,05; 95% CI=−0,34 bis 0,43; P=0,82) und der mentalen Lebensqualität (Standardabweichung mittlere Differenz=0,04; 95% CI=−0,25 bis 0,34; P=0,77) festgestellt werden.

Schlussfolgerung Im Vergleich zu herkömmlichen Maßnahmen konnte mit Sport in der Gruppe eine signifikante Verbesserung des 6-Minuten-Gehtests und der Gehgeschwindigkeit erzielt werden, es zeigte sich jedoch keine Wirkung auf der Berg-Balance-Skala, der Muskelkraft und mentalen Lebensqualität.

Key words

early rehabilitation - exercise therapy - Medical rehabilitation

Schlüsselwörter

Frührehabilitation - Bewegungstherapie - Rehabilitation

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