Physical fitness training for stroke patients (Review)

Background Levels of physical activity and physical fitness are low aKer stroke. Interventions to increase physical fitness could reduce mortality and reduce disability through increased function. Objectives The primary objectives of this updated review were to determine whether fitness training aKer stroke reduces death, death or dependence, and disability. The secondary objectives were to determine the eMects of training on adverse events, risk factors, physical fitness, mobility, physical function, health status and quality of life, mood, and cognitive function. Search methods In July 2018 we searched the Cochrane Stroke Trials Register, CENTRAL, MEDLINE, Embase, CINAHL, SPORTDiscus, PsycINFO, and four additional databases. We also searched ongoing trials registers and conference proceedings, screened reference lists, and contacted experts in the field. Selection criteria Randomised trials comparing either cardiorespiratory training or resistance training, or both (mixed training), with usual care, no intervention, or a non-exercise intervention in stroke survivors. Data collection and analysis Two review authors independently selected studies, assessed quality and risk of bias, and extracted data. We analysed data using randome Mects meta-analyses and assessed the quality of the evidence using the GRADE approach. Diverse outcome measures limited the intended analyses. Main results We included 75 studies, involving 3017 mostly ambulatory participants, which comprised cardiorespiratory (32 studies, 1631 participants), resistance (20 studies, 779 participants), and mixed training interventions (23 studies, 1207 participants).