Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2025 Feb 3;59(3):185-197.
doi: 10.1136/bjsports-2024-108476.

Prescribing strength training for stroke recovery: a systematic review and meta-analysis of randomised controlled trials

Kenneth S Noguchi  1 , Kevin Moncion  1 , Elise Wiley  1 , Ashley Morgan  1 , Eric Huynh  1 , Guilherme Moraes Balbim  2 , Brad Elliott  3 , Carlene Harris-Blake  3 , Brent Krysa  3 , Barb Koetsier  3 , Karolyn Pinili  3 , Marla K Beauchamp  1 , Stuart M Phillips  4 , Lehana Thabane  5   6 , Ada Tang  7
Affiliations
Meta-Analysis

Prescribing strength training for stroke recovery: a systematic review and meta-analysis of randomised controlled trials

Kenneth S Noguchi et al. Br J Sports Med. .

Abstract

Objective: To examine the effects of strength training on patient-important outcomes of stroke recovery and to quantify the influence of the exercise prescription on treatment effects.

Design: Systematic review and meta-analysis.

Data sources: Eight electronic databases (MEDLINE, EMBASE, EMCARE, AMED, PsycINFO, CINAHL, SPORTDiscus, and Web of Science) and two clinical trial registries (ClinicalTrials.gov and WHO International Clinical Trials Registry Platform) were searched from inception to 19 June 2024.

Eligibility criteria: Randomised controlled trials were eligible if they examined the effects of strength training compared with no exercise or usual care and reported at least one exercise prescription parameter. An advisory group of community members with lived experience of stroke helped inform outcomes most relevant to stroke recovery.

Results: Forty-two randomised trials (N=2204) were included. Overall risk of bias was high across most outcomes. Strength training improved outcomes rated as 'critical for decision-making' by the advisory group, including walking capacity (standardised mean difference (SMD)=0.95 (95% CI 0.34-1.56)), balance (SMD=1.13 (0.51-1.75)), functional ability and mobility (SMD=0.61 (0.09-1.14)), and habitual (mean difference (MD)=0.05 m/s (0.02-0.09)) and fast-paced walking speed (MD=0.09 m/s (0.01-0.17)), with very low to moderate certainty of evidence, mainly due to risk of bias and inconsistency. More frequent strength training, traditional strength training programmes and power-focused intensities (ie, emphasis on movement velocity) were positively associated with walking capacity, health-related quality of life and fast-paced walking speed.

Conclusion: Strength training alone or combined with usual care improves stroke recovery outcomes that are important for decision-making. More frequent strength training, power-focused intensities and traditional programme designs may best support stroke recovery.

Prospero registration number: CRD42023414077.

Keywords: Exercise Therapy; Meta-analysis; Neurological rehabilitation.

PubMed Disclaimer

Conflict of interest statement

Competing interests: SMP reports grants or contracts currently held or in the last 5 years from the US National Dairy Council, Dairy Farmers of Canada, Roquette Freres, Nestle Health Sciences, National Science and Engineering Research Council, Canadian Institutes for Health Research and the US NIH during the conduct of the study; personal fees from US National Dairy Council, non-financial support from Enhanced Recovery, outside the submitted work. In addition, SMP has a patent Canadian and US patents assigned to Exerkine, but reports no financial gains from any patent or related work. KSN is supported by an Ontario Graduate Scholarship and the McMaster Collaborative for Health and Aging Trainee Engagement Fund. The Trainee Engagement Fund provided financial support for the community advisory group of people with lived experience. There was no other specific funding for this work. KM is supported by an Ontario Graduate Scholarship. EW is supported by MIRA and AGEWELL NCE Inc., a member of the Networks of Centres of Excellence programme. EH was supported by a Canadian Institute for Health Research-Masters (CIHR CGSM) Scholarship. GMB is jointly funded by the Canadian Institutes of Health Research and Michael Smith Health Research BC. MKB and SMP are supported by the Canada Research Chairs Program. AT was supported by a Clinician-Scientist Award (Phase II) from the Ontario Heart and Stroke Foundation (P-19-TA-1192).

LinkOut - more resources