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Review
. 2024 Sep 17;13(18):5498.
doi: 10.3390/jcm13185498.

High-Intensity Exercise Training Impact on Cardiorespiratory Fitness, Gait Ability, and Balance in Stroke Survivors: A Systematic Review and Meta-Analysis

Alessio Baricich  1   2 , Margherita Beatrice Borg  3   4 , Marco Battaglia  3   4 , Salvatore Facciorusso  5 , Stefania Spina  5 , Marco Invernizzi  3   6 , Lorenza Scotti  7 , Lucia Cosenza  4 , Alessandro Picelli  8 , Andrea Santamato  5
Affiliations
Review

High-Intensity Exercise Training Impact on Cardiorespiratory Fitness, Gait Ability, and Balance in Stroke Survivors: A Systematic Review and Meta-Analysis

Alessio Baricich et al. J Clin Med. .

Abstract

Stroke survivors commonly face challenges such as reduced physical activity and cardiorespiratory fitness (CRF) as well as balance and gait impairments, exacerbating their disability. While high-intensity exercise interventions have demonstrated some potential, their effects on these items remain uncertain. Therefore, our study aimed to investigate the impact of high-intensity training protocols on CRF, gait ability, and balance in stroke survivor populations. Two independent investigators systematically searched five databases for relevant RCTs following the PICO model. Through a systematic review of 25 RCTs published up to 31 May 2023, including adult first-stroke survivors, comparing high-intensity exercise training versus low-to-mild or no exercises, we evaluated outcomes such as the Six-Minute Walking Test (6 MWT), peak oxygen uptake (VO2peak), Ten-Meter Walk Test (10 MWT), Berg Balance Scale (BBS), and Timed Up and Go test (TUG). The protocol was registered in PROSPERO (registration number CRD42023456773). Meta-analyses indicated significant enhancements in CRF, as measured by 6 MWT and VO2peak, following high-intensity exercise interventions. However, no significant differences were observed in BBS, 10 MWT, and TUG. Our findings underscore the potential of high-intensity exercise interventions in ameliorating CRF among stroke survivors, although further research involving standardized protocols and long-term follow-ups is imperative to optimize rehabilitation outcomes.

Keywords: cardio-respiratory fitness; high-intensity exercise; high-intensity training; meta-analysis; rehabilitation; stroke.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA 2020 flow diagram for new systematic reviews.
Figure 2
Figure 2
Risk of bias assessment [51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75].
Figure 3
Figure 3
The 6 MWT forest plot [53,55,56,57,58,59,62,63,64,67,68,69,70,71,72,73,74,75].
Figure 4
Figure 4
The 6 MWT funnel plot.
Figure 5
Figure 5
VO2peak forest plot [52,53,54,56,57,60,61,62,63,65,66,67,69,70,71,72,73,74,75].
Figure 6
Figure 6
VO2peak funnel plot.
Figure 7
Figure 7
The 10 MWT forest plot [51,52,53,55,56,62,64,69,70,72,73].
Figure 8
Figure 8
The 10 MWT funnel plot.
Figure 9
Figure 9
BBS forest plot [51,55,56,58,63,64].
Figure 10
Figure 10
BBS funnel plot.
Figure 11
Figure 11
TUG forest plot [51,55,70].
See this image and copyright information in PMC

References

    1. Benjamin E.J., Muntner P., Alonso A., Bittencourt M.S., Callaway C.W., Carson A.P., Chamberlain A.M., Chang A.R., Cheng S., Das S.R., et al. Heart Disease and Stroke Statistics—2019 Update: A Report from the American Heart Association. Circulation. 2019;139:e56–e528. doi: 10.1161/CIR.0000000000000659. - DOI - PubMed
    1. Martin S.S., Aday A.W., Almarzooq Z.I., Anderson C.A., Arora P., Avery C.L., Baker-Smith C.M., Gibbs B.B., Beaton A.Z., Boehme A.K., et al. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation. 2024;149:e347–e913. doi: 10.1161/CIR.0000000000001209. - DOI - PubMed
    1. Billinger S.A., Arena R., Bernhardt J., Eng J.J., Franklin B.A., Johnson C.M., MacKay-Lyons M., Macko R.F., Mead G.E., Roth E.J., et al. Physical activity and exercise recommendations for stroke survivors: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45:2532–2553. doi: 10.1161/STR.0000000000000022. - DOI - PubMed
    1. Langhorne P., Bernhardt J., Kwakkel G. Stroke rehabilitation. Lancet. 2011;377:1693–1702. doi: 10.1016/S0140-6736(11)60325-5. - DOI - PubMed
    1. Saunders D.H., Greig C.A., Mead G.E. Physical activity and exercise after stroke: Review of multiple meaningful benefits. Stroke. 2014;45:3742–3747. doi: 10.1161/STROKEAHA.114.004311. - DOI - PubMed

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