Cardiorespiratory strain during stroke rehabilitation: Are patients trained enough? A systematic review.


Journal

Annals of physical and rehabilitation medicine
ISSN: 1877-0665
Titre abrégé: Ann Phys Rehabil Med
Pays: Netherlands
ID NLM: 101502773

Informations de publication

Date de publication:
Jul 2021
Historique:
received: 27 04 2020
revised: 14 09 2020
accepted: 18 09 2020
pubmed: 21 10 2020
medline: 21 10 2021
entrez: 20 10 2020
Statut: ppublish

Résumé

Rehabilitation is a mandatory component of stroke management, aiming to recover functional capacity and independence. To that end, physical therapy sessions must involve adequate intensity in terms of cardiopulmonary stress to meet the physiological demands of independent living. The aim of this systematic review was to determine the current level of cardiopulmonary strain during rehabilitation sessions in stroke patients. Three electronic databases (PubMed, CINAHL and Embase. com) were searched to identify observational studies that documented cardiopulmonary strain during rehabilitation sessions in post-stroke patients (last search performed in February 2019). A manual cross-referencing search was also performed. To be included, articles needed to report data related to both cardiopulmonary strain (heart rate, oxygen consumption or energy expenditure) and active therapy time. The methodological quality of each study was assessed with the Evidence-Based Librarianship Critical Appraisal Tool. Data related to both cardiorespiratory strain and active therapy time were extracted from selected articles. Four of 43 full-text articles assessed for eligibility met the inclusion criteria. Results extracted from these articles suggested that the intensity of rehabilitation sessions was insufficient to induce a cardiopulmonary training effect in a post-stroke context as measured by metabolic stress. Patients were inactive from 21% to 80% of the therapy time. The Evidence-Based Librarianship tool scores ranged from 65% (15/23) to 91% (21/23), which indicates questionable to good quality. The current literature on cardiopulmonary solicitation during stroke rehabilitation sessions is poor in terms of both the number of studies available and their methodological quality. Summarized results tend to support previous claims that rehabilitation sessions offered to stroke patients are of suboptimal cardiopulmonary strain, which can interfere with their capacity to regain functional independence.

Sections du résumé

BACKGROUND BACKGROUND
Rehabilitation is a mandatory component of stroke management, aiming to recover functional capacity and independence. To that end, physical therapy sessions must involve adequate intensity in terms of cardiopulmonary stress to meet the physiological demands of independent living.
OBJECTIVE OBJECTIVE
The aim of this systematic review was to determine the current level of cardiopulmonary strain during rehabilitation sessions in stroke patients.
METHODS METHODS
Three electronic databases (PubMed, CINAHL and Embase. com) were searched to identify observational studies that documented cardiopulmonary strain during rehabilitation sessions in post-stroke patients (last search performed in February 2019). A manual cross-referencing search was also performed. To be included, articles needed to report data related to both cardiopulmonary strain (heart rate, oxygen consumption or energy expenditure) and active therapy time. The methodological quality of each study was assessed with the Evidence-Based Librarianship Critical Appraisal Tool. Data related to both cardiorespiratory strain and active therapy time were extracted from selected articles.
RESULTS RESULTS
Four of 43 full-text articles assessed for eligibility met the inclusion criteria. Results extracted from these articles suggested that the intensity of rehabilitation sessions was insufficient to induce a cardiopulmonary training effect in a post-stroke context as measured by metabolic stress. Patients were inactive from 21% to 80% of the therapy time. The Evidence-Based Librarianship tool scores ranged from 65% (15/23) to 91% (21/23), which indicates questionable to good quality.
CONCLUSION CONCLUSIONS
The current literature on cardiopulmonary solicitation during stroke rehabilitation sessions is poor in terms of both the number of studies available and their methodological quality. Summarized results tend to support previous claims that rehabilitation sessions offered to stroke patients are of suboptimal cardiopulmonary strain, which can interfere with their capacity to regain functional independence.

Identifiants

pubmed: 33080374
pii: S1877-0657(20)30188-3
doi: 10.1016/j.rehab.2020.09.007
pii:
doi:

Types de publication

Journal Article Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

101443

Informations de copyright

Copyright © 2020 Elsevier Masson SAS. All rights reserved.

Auteurs

Vicky Girard (V)

Department of rehabilitation, Laval University, 1050, avenue de la Médecine, QC, G1V0A6 Quebec, Canada.

Hubert Bellavance-Tremblay (H)

Department of rehabilitation, Laval University, 1050, avenue de la Médecine, QC, G1V0A6 Quebec, Canada.

Gabrielle Gaudet-Drouin (G)

Department of rehabilitation, Laval University, 1050, avenue de la Médecine, QC, G1V0A6 Quebec, Canada.

Geneviève Lessard (G)

Centre for Interdisciplinary Research in Rehabilitation and Social Integration, 525, boulevard Wilfrid-Hamel, QC, G1M 2S8 Quebec City, Canada.

Myriam Dupont (M)

Laval University Library, 2345, allée des Bibliothèques, QC, G1V0A6, Quebec, Canada.

Marie-Andrée Gagnon (MA)

Centre for Interdisciplinary Research in Rehabilitation and Social Integration, 525, boulevard Wilfrid-Hamel, QC, G1M 2S8 Quebec City, Canada.

Armelle M Ngueleu (AM)

Centre for Interdisciplinary Research in Rehabilitation and Social Integration, 525, boulevard Wilfrid-Hamel, QC, G1M 2S8 Quebec City, Canada.

Stéphane Mandigout (S)

Laboratory HAVAE EA-6310, University of Limoges, 123, avenue Albert Thomas, 87060 Limoges, France.

Charles Sebiyo Batcho (CS)

Department of rehabilitation, Laval University, 1050, avenue de la Médecine, QC, G1V0A6 Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation and Social Integration, 525, boulevard Wilfrid-Hamel, QC, G1M 2S8 Quebec City, Canada. Electronic address: charles.batcho@fmed.ulaval.ca.

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