What Is the Dose-Response Relationship Between Exercise and Cardiorespiratory Fitness After Stroke? A Systematic Review.

Cardiorespiratory Fitness Exercise Therapy Humans Stroke Rehabilitation

Journal

Physical therapy
ISSN: 1538-6724
Titre abrégé: Phys Ther
Pays: United States
ID NLM: 0022623

Informations de publication

Date de publication:
01 07 2019
Historique:
received: 09 02 2018
accepted: 30 09 2018
pubmed: 6 3 2019
medline: 18 12 2019
entrez: 6 3 2019
Statut: ppublish

Résumé

Exercise after stroke improves cardiorespiratory fitness and walking capacity; however, the effect of altering exercise dose (via frequency, intensity, time, and type) on fitness or walking capacity is unclear. The purpose of this study was to synthesize the current evidence for the effects of different doses of exercise on cardiorespiratory fitness and walking capacity in people after stroke. Seven relevant electronic databases were searched using keywords relating to stroke and cardiorespiratory fitness. Trials that compared more than 1 dose of exercise for people (≥ 18 years old) after stroke and measured peak oxygen consumption or 6-minute walk test distance as an outcome were included. Two reviewers independently appraised all trials. Two reviewers independently extracted data from included articles. Intervention variables were extracted in accordance with the Template for Intervention Description and Replication checklist. Data were synthesized narratively. Nine trials involving 279 participants were included. Three of 5 trials comparing exercise intensity showed that higher-intensity training was associated with greater improvements in cardiorespiratory fitness. The effects of other exercise dose components (frequency, time, and type) on fitness were not determined. Overall, walking capacity improved as program length increased. All trials had a high risk of bias, and most had a high rate of attrition. Most trials included people more than 6 months after stroke and who walked independently, limiting the generalizability of the findings. Exercising at an intensity greater than 70% of heart rate reserve can be more effective in increasing cardiorespiratory fitness after stroke than exercising at lower intensities. More trials that compare exercise doses by manipulating only 1 dose parameter at a time for people after stroke are needed.

Sections du résumé

BACKGROUND
Exercise after stroke improves cardiorespiratory fitness and walking capacity; however, the effect of altering exercise dose (via frequency, intensity, time, and type) on fitness or walking capacity is unclear.
PURPOSE
The purpose of this study was to synthesize the current evidence for the effects of different doses of exercise on cardiorespiratory fitness and walking capacity in people after stroke.
DATA SOURCES
Seven relevant electronic databases were searched using keywords relating to stroke and cardiorespiratory fitness.
STUDY SELECTION
Trials that compared more than 1 dose of exercise for people (≥ 18 years old) after stroke and measured peak oxygen consumption or 6-minute walk test distance as an outcome were included. Two reviewers independently appraised all trials.
DATA EXTRACTION
Two reviewers independently extracted data from included articles. Intervention variables were extracted in accordance with the Template for Intervention Description and Replication checklist.
DATA SYNTHESIS
Data were synthesized narratively. Nine trials involving 279 participants were included. Three of 5 trials comparing exercise intensity showed that higher-intensity training was associated with greater improvements in cardiorespiratory fitness. The effects of other exercise dose components (frequency, time, and type) on fitness were not determined. Overall, walking capacity improved as program length increased.
LIMITATIONS
All trials had a high risk of bias, and most had a high rate of attrition. Most trials included people more than 6 months after stroke and who walked independently, limiting the generalizability of the findings.
CONCLUSIONS
Exercising at an intensity greater than 70% of heart rate reserve can be more effective in increasing cardiorespiratory fitness after stroke than exercising at lower intensities. More trials that compare exercise doses by manipulating only 1 dose parameter at a time for people after stroke are needed.

Identifiants

DOI: 10.1093/ptj/pzz038 PMID: 30834439
pubmed: 30834439
pii: 5369494
doi: 10.1093/ptj/pzz038
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

821-832

Commentaires et corrections

Type : ErratumIn

Informations de copyright

© 2019 American Physical Therapy Association.

Auteurs

Margaret Galloway (M)

School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, University Drive, Callaghan, New South Wales 2305, Australia; and Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Hunter Medical Research Institute, Newcastle, New South Wales, Australia.

Dianne L Marsden (DL)

School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle; Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Hunter Medical Research Institute; and Hunter Stroke Service, Hunter New England Local Health District, Newcastle, New South Wales, Australia.

Robin Callister (R)

Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Hunter Medical Research Institute; and School of Biomedical Sciences and Pharmacy and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle.

Kirk I Erickson (KI)

Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania.

Michael Nilsson (M)

Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Hunter Medical Research Institute; and Faculty of Health and Medicine, University of Newcastle.

Coralie English (C)

School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle; and Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Hunter Medical Research Institute.

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Classifications MeSH

questionsmedicales.fr › Caractéristiques de la population › Santé › Aptitude physique › Capacité cardiorespiratoire › What Is the Dose-Response Relationship Between...
questionsmedicales.fr › Thérapeutique › Techniques de physiothérapie › Traitement par les exercices physiques › What Is the Dose-Response Relationship Between...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › What Is the Dose-Response Relationship Between...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Réadaptation › Rééducation neurologique › Réadaptation après un accident vasculaire cérébral › What Is the Dose-Response Relationship Between...