In the first 3 months after stroke is progressive resistance training safe and does it improve activity? A systematic review

Abstract

BACKGROUND Progressive resistance training (PRT) can improve strength and function in people with chronic stroke, but less is known about whether this intervention is safe and beneficial during the first 3 months following stroke. OBJECTIVE To systematically review the evidence about the safety and effectiveness of PRT to improve activity in people within the first 3 months after stroke. METHODS After database searching and selection of studies a risk of bias assessment was conducted. Data for the primary outcome of safety was synthesised descriptively and meta-analyses for other outcomes were conducted using a random effects model. RESULTS The quality of the 5 included studies ranged from good to excellent (mean 24.2, range 20-28). For the trials investigating adverse events, none reported any significant increase in events after PRT. There was high level evidence that PRT had little or no effect on strength (SMD (standardized mean difference) 0.17, 95% CI -0.16 to 0.50, I(2) = 0%). There were no significant benefit for upper limb function (SMD 0.11, 95% CI -0.41 to 0.63, I(2) = 0%) and mobility (SMD 0.11, 95% CI -0.21 to 0.43, I(2) = 27%) after PRT compared with controls. CONCLUSIONS There was no evidence reported that PRT is unsafe in people within the first 3 months after stroke, although there was a lack of reporting about adverse events. The lack of demonstration of effect in improving muscle strength and activity suggests there is insufficient evidence to recommend the prescription of PRT for people within the first 3 months after stroke.

Keywords: Adverse effects; Muscle strength; Rehabilitation; Resistance training; Stroke.