Article

OBJECTIVE: To assess the influence of dosing parameters and patient
characteristics on the efficacy of aerobic exercise (AEX) poststroke. DATA SOURCES:
A systematic review was conducted using PubMed, MEDLINE, Cumulative
Index of Nursing and Allied Health Literature, Physiotherapy Evidence Database,
and Academic Search Complete. STUDY SELECTION:
Studies were selected that
compared an AEX group with a nonaerobic control group among ambulatory persons
with stroke. DATA EXTRACTION: Extracted outcome data included peak oxygen
consumption (V o2peak) during exercise testing, walking speed, and walking
endurance (6-min walk test). Independent variables of interest were AEX mode
(seated or walking), AEX intensity (moderate or vigorous), AEX volume (total
hours), stroke chronicity, and baseline outcome scores. DATA SYNTHESIS:
Significant between-study heterogeneity was confirmed for all outcomes. Pooled
AEX effect size estimates (AEX group change minus control group change) from
random effects models were V o2peak, 2.2mLkg-1min-1 (95% confidence interval
[CI], 1.3-3.1mLkg-1min-1); walking speed, .06m/s (95% CI, .01-.11m/s); and
6-minute walk test distance, 29m (95% CI, 15-42m). In meta-regression, larger V
o2peak effect sizes were significantly associated with higher AEX intensity and
higher baseline V o2peak. Larger effect sizes for walking speed and the 6-minute
walk test were significantly associated with a walking AEX mode. In contrast,
seated AEX did not have a significant effect on walking outcomes. CONCLUSIONS:
AEX significantly improves aerobic capacity poststroke, but may need to be task
specific to affect walking speed and endurance. Higher AEX intensity is
associated with better outcomes. Future randomized studies are needed to confirm these results.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS