Article

Cardiorespiratory fitness is low after stroke. Improving fitness has
the potential to improve function and reduce secondary cardiovascular events.
This review with meta-analysis aims to identify characteristics and
determine the effectiveness of interventions to improve cardiorespiratory fitness
after stroke. METHODS: A systematic search and review with meta-analysis was
undertaken. Key inclusion criteria were the following: peer-reviewed articles
published in English, adult stroke survivors, an intervention with the potential
to improve cardiorespiratory fitness, and peak oxygen consumption (VO2peak)
assessed preintervention and postintervention via a progressive aerobic exercise
test. RESULTS: From 3209 citations identified, 28 studies were included,
reporting results for 920 participants. Studies typically included chronic,
ambulant participants with mild to moderate deficits; used an aerobic or mixed
(with an aerobic component) intervention; and prescribed 3 sessions per week for
30 to 60 minutes per session at a given intensity. Baseline VO2peak values were
low (8-23 mL/kg/min). Meta-analysis of the 12 randomized controlled trials
demonstrated overall improvements in VO2peak of 2.27 (95% confidence interval =
1.58, 2.95) mL/kg/min postintervention. A similar 10% to 15% improvement occurred
with both aerobic and mixed interventions and in shorter (</= 3 months) and
longer (>3 months) length programs. Only 1 study calculated total dose received
and only 1 included long-term follow-up. CONCLUSIONS:
The results demonstrate
that interventions with an aerobic component can improve cardiorespiratory
fitness poststroke. Further investigation is required to determine effectiveness
in those with greater impairment and comorbidities, optimal timing and dose of
intervention, whether improvements can be maintained in the longer term, and
whether improved fitness results in better function and reduced risk of subsequent cardiovascular events.

Langue : ANGLAIS