Physical fitness training for stroke patients (Review) - Update Software

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Analysis 7.1. Comparison 7 Cardiorespiratory versus resistance versus mixed training, Outcome 1 Mobility - gait preferred speed (m/min). Review: Physical fitness training for stroke patients Comparison: 7 Cardiorespiratory versus resistance versus mixed training Outcome: 1 Mobility - gait preferred speed (m/min) Study or subgroup Training Control Mean Difference Weight Mean Difference 1 Cardiorespiratory training N Mean(SD) N Mean(SD) IV,Random,95% CI IV,Random,95% CI Cuviello-Palmer 1988 10 18.11 (9.22) 10 12.07 (6.41) 22.2 % 6.04 [ -0.92, 13.00 ] Katz-Leurer 2003 46 30.6 (10.8) 44 27 (9.6) 60.5 % 3.60 [ -0.62, 7.82 ] Moore 2010 10 37.8 (18) 10 34.8 (13.8) 5.4 % 3.00 [ -11.06, 17.06 ] Salbach 2004 44 46.8 (24) 47 38.4 (22.2) 11.9 % 8.40 [ -1.12, 17.92 ] Subtotal (95% CI) 110 111 100.0 % 4.68 [ 1.40, 7.96 ] Heterogeneity: Tau 2 = 0.0; Chi 2 = 1.04, df = 3 (P = 0.79); I 2 =0.0% Test for overall effect: Z = 2.80 (P = 0.0052) 2 Mixed training Cooke 2010 36 25.2 (23.4) 38 18 (21) 6.3 % 7.20 [ -2.95, 17.35 ] Duncan 2003 50 10.8 (12.6) 50 6.6 (8.4) 17.6 % 4.20 [ 0.00, 8.40 ] James 2002 10 12 (1.68) 8 12 (1.68) 25.7 % 0.0 [ -1.56, 1.56 ] Mead 2007 32 44.1 (6.3) 33 44.1 (6.42) 21.1 % 0.0 [ -3.09, 3.09 ] Richards 1993 9 18.78 (11.88) 8 13.5 (8.76) 6.6 % 5.28 [ -4.57, 15.13 ] Richards 2004 31 33 (21) 31 36 (21.6) 5.9 % -3.00 [ -13.60, 7.60 ] Teixeira 1999 6 61.8 (24) 7 46.8 (22.2) 1.3 % 15.00 [ -10.28, 40.28 ] Yang 2006 24 55.5 (8.1) 24 46.62 (9.24) 15.5 % 8.88 [ 3.96, 13.80 ] Subtotal (95% CI) 198 199 100.0 % 2.93 [ 0.02, 5.84 ] Heterogeneity: Tau 2 = 7.97; Chi 2 = 17.92, df = 7 (P = 0.01); I 2 =61% Test for overall effect: Z = 1.97 (P = 0.048) 3 Resistance training Bale 2008 8 13.8 (6) 10 4.8 (6) 39.0 % 9.00 [ 3.42, 14.58 ] Kim 2001 10 2.4 (7.8) 10 5.4 (4.2) 39.2 % -3.00 [ -8.49, 2.49 ] Ouellette 2004 21 38.4 (22) 21 38.4 (24.75) 21.7 % 0.0 [ -14.16, 14.16 ] Subtotal (95% CI) 39 41 100.0 % 2.34 [ -6.77, 11.45 ] Heterogeneity: Tau 2 = 47.20; Chi 2 = 9.18, df = 2 (P = 0.01); I 2 =78% Test for overall effect: Z = 0.50 (P = 0.61) Physical fitness training for stroke patients (Review) Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. -50 -25 0 25 50 Favours control Favours training 223
Analysis 7.2. Comparison 7 Cardiorespiratory versus resistance versus mixed training, Outcome 2 Mobility - gait preferred speed (m/min); sensitivity analysis: confounded studies removed. Review: Physical fitness training for stroke patients Comparison: 7 Cardiorespiratory versus resistance versus mixed training Outcome: 2 Mobility - gait preferred speed (m/min); sensitivity analysis: confounded studies removed Study or subgroup Training Control Mean Difference Weight Mean Difference 1 Cardiorespiratory training N Mean(SD) N Mean(SD) IV,Random,95% CI IV,Random,95% CI Cuviello-Palmer 1988 10 18.11 (9.22) 10 12.07 (6.41) 65.2 % 6.04 [ -0.92, 13.00 ] Salbach 2004 44 46.8 (24) 47 38.4 (22.2) 34.8 % 8.40 [ -1.12, 17.92 ] Subtotal (95% CI) 54 57 100.0 % 6.86 [ 1.24, 12.48 ] Heterogeneity: Tau 2 = 0.0; Chi 2 = 0.15, df = 1 (P = 0.69); I 2 =0.0% Test for overall effect: Z = 2.39 (P = 0.017) 2 Mixed training Cooke 2010 36 25.2 (23.4) 38 18 (21) 11.0 % 7.20 [ -2.95, 17.35 ] Mead 2007 32 44.1 (6.3) 33 44.1 (6.42) 78.9 % 0.0 [ -3.09, 3.09 ] Richards 2004 31 33 (21) 31 36 (21.6) 10.1 % -3.00 [ -13.60, 7.60 ] Subtotal (95% CI) 99 102 100.0 % 0.49 [ -2.96, 3.94 ] Heterogeneity: Tau 2 = 1.44; Chi 2 = 2.18, df = 2 (P = 0.34); I 2 =8% Test for overall effect: Z = 0.28 (P = 0.78) 3 Resistance training Bale 2008 8 13.8 (6) 10 4.8 (6) 39.0 % 9.00 [ 3.42, 14.58 ] Kim 2001 10 2.4 (7.8) 10 5.4 (4.2) 39.2 % -3.00 [ -8.49, 2.49 ] Ouellette 2004 21 38.4 (22) 21 38.4 (24.75) 21.7 % 0.0 [ -14.16, 14.16 ] Subtotal (95% CI) 39 41 100.0 % 2.34 [ -6.77, 11.45 ] Heterogeneity: Tau 2 = 47.20; Chi 2 = 9.18, df = 2 (P = 0.01); I 2 =78% Test for overall effect: Z = 0.50 (P = 0.61) A D D I T I O N A L T A B L E S -50 -25 0 25 50 Favours control Favours training Table 1. Outline of the studies which focused on cardiorespiratory training interventions Study ID Mode of training During or after usual care Upper or lower body Specific training Intensity Duration (minutes) Physical fitness training for stroke patients (Review) Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Frequency (days) Programme length (weeks) ACSM criteria met 224
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Physical fitness training for strok
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Analysis 1.19. Comparison 1 Cardior
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Analysis 5.10. Comparison 5 Mixed t
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Analysis 7.2. Comparison 7 Cardiore
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walking speed (mean difference (MD)
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Post-stroke physical activity and f
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Search methods for identification o
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• type of training (cardiorespira
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Compliance with the scheduled exerc
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Case fatality Number of deaths was
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we did not include these data in th
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(Flansbjer 2008; Kim 2001; Ouellett
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data were, however, confounded by a
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Vascular risk factors A few trials
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ical function outcomes did not impr
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We thank the Cochrane Stroke Group
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or relaxation. Proceedings of the U
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Dean 1997 {published data only} Dea
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(LEAPS): a randomized controlled tr
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with chronic stroke. Neurorehabilit
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Askim {published data only} Askim T
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Hobart 2002 Hobart JC, Williams LS,
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andomized controlled trials. Clinic
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Bale 2008 Methods Design: randomise
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Cooke 2010 Methods Design: phase I
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da Cunha 2002 Methods Design: rando
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Duncan 1998 Methods Design: randomi
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Eich 2004 Methods Design: randomise
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Flansbjer 2008 (Continued) Allocati
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James 2002 Methods Design: randomis
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Kim 2001 Methods Design: randomised
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Lennon 2008 Methods Design: pilot r
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Moore 2010 Methods Design: randomis
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Mudge 2009 (Continued) sessions (e.
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Pohl 2002 (Continued) Exclusion cri
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Richards 1993 (Continued) Intervent
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Salbach 2004 (Continued) Interventi
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Smith 2008 (Continued) Inclusion cr
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Winstein 2004 (Continued) sive hydr
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mAS: modified Ashworth Scale MAS: M
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(Continued) Franceschini 2009 Not v
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(Continued) Maeshima 2003 Not a rel
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(Continued) Thielman 2005 Not a rel
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Eng Trial name or title The effect
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Ivey (B) Trial name or title Streng
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Protas (Continued) Participants 48
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Suskin 2007 (Continued) Time frame:
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Wolff Trial name or title Effects o
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11.2 After usual care 3 169 Mean Di
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7 Physical fitness - maximum cyclin
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10.2 After usual care 1 20 Mean Dif
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13 Physical fitness - muscle streng
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36 Mood - Hospital Anxiety and Depr
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21.2 After usual care 1 80 Mean Dif
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Analysis 3.1. Comparison 3 Resisten
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Analysis 3.11. Comparison 3 Resiste
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Analysis 5.1. Comparison 5 Mixed tr
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