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

data were, however, confounded by additional training time. After
removal of these data from the analysis no significant training
effect was evident (MD -1.13 seconds, 95% CI -2.91 to 0.65)
(Analysis 5.27). Follow-up data from the two unconfounded trials
(Mead 2007; Richards 2004) did not show a significant retention
of mixed training benefits (Analysis 6.15).
One trial assessed upper extremity functional performance using
the nine hole peg test (for fine motor coordination) and the Action
Research Arm test (Donaldson 2009). No significant training
effects were observed in either test at the end of intervention
(Analysis 5.24; Analysis 5.25).
Health status and quality of life
Cardiorespiratory training (Comparisons 1 and 2)
Only one trial assessed the effects of cardiorespiratory training
on measures of quality of life, in 28 participants (Aidar 2007).
Both the SF-36 physical component score and the SF-36 emotion
score were significantly better at the end of the training period in
participants who underwent cardiorespiratory training (Analysis
1.22; Analysis 1.23).
Resistance training (Comparisons 3 and 4)
One small trial of 20 participants (Kim 2001) did not show any
significant differences between the resistance training group and
the control group in either the physical health or mental health
component of the SF-36 at the end of intervention (Analysis 3.10;
Analysis 3.11).
Mixed training (Comparisons 5 and 6)
One trial (Cooke 2010) measured the effects of mixed training
on quality of life in 50 participants using two components of the
EuroQuol scale. Scores were not significantly different between
intervention groups at the end of the training phase (Analysis 5.28;
Analysis 5.29) or at follow-up (Analysis 6.16; Analysis 6.17).
A few trials assessed the effects of mixed training on quality of
life using different components of the SF-36 survey questionnaire.
In two trials with a total of 112 participants (Duncan 2003;
James 2002) significantly better scores were obtained in the SF-36
physical functioning component in the mixed training group at the
end of intervention (SMD 0.48, 95% CI 0.10 to 0.85) (Analysis
5.30) but not in the social role functioning component (Analysis
5.31). Three trials with a total of 178 participants (Duncan 2003;
James 2002; Mead 2007) showed significantly better scores in the
SF-36 physical role functioning for the mixed training group at the
end of intervention (SMD 0.56, 95% CI 0.26 to 0.86) (Analysis
5.32). This effect was retained at follow-up (Analysis 6.19).
One trial (Duncan 2003) showed that participants receiving mixed
training had significantly better results in the emotional role functioning
component of the SF-36 compared with controls at the
end of the training period (Analysis 5.33) but not at follow-up
(Analysis 6.20).
It is worth noting that in the Duncan 2003 and James 2002 trials
the intervention group was potentially confounded by additional
training time.
Mood
Physical fitness training for stroke patients (Review)
Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cardiorespiratory training (Comparisons 1 and 2)
One trial (Smith 2008) assessed the potential benefits of cardiorespiratory
training on depression symptoms using the Beck Depression
Index. No significant differences were found between intervention
groups at the end of intervention (Analysis 1.24) and at
follow-up (Analysis 2.16).
One trial (Bateman 2001) assessed participants using the anxiety
and depression components of the Hospital Anxiety and Depression
Scale (HADS). The anxiety score decreased immediately after
cardiorespiratory training (MD -1.94, 95% CI -3.80 to 0.08)
(Analysis 1.25) but this small benefit was not retained at the followup
assessment (Analysis 2.17). In contrast, the depression score
was not significantly different between groups at the end of the
training phase (Analysis 1.26) but decreased significantly in the
cardiorespiratory group at the end of the follow-up period (MD -
2.70, 95% CI -4.40 to -1.00) (Analysis 2.18). This trial had, however,
substantial missing values at the end of intervention (29%)
and end of follow up (37%) and therefore these findings should
be interpreted with caution. Another trial (Lennon 2008), which
measured participants’ mood using the HADS, reported that the
depression score improved in the intervention group but not in
the control group. We were, however, unable to include these trial
data in out analyses as they were presented in a format not suitable
for RevMan.
Resistance training (Comparisons 3 and 4)
One trial (Sims 2009) assessed 88 participants using the Centre for
Epidemiological Studies for Depression scale (CES-D). The mood
in the resistance training group was significantly better at the end
of intervention (MD -5.49, 95% CI -9.78 to -1.20) (Analysis 3.12)
and at follow-up (MD -8.92, 95% CI -13.03 to -4.81) (Analysis
4.6).
Mixed training (Comparisons 5 and 6)
One trial (Duncan 2003) assessed participants’ mood using both
the emotion domain of the Stroke Impact Scale (SIS) and the
Geriatric Depression Scale. SIS emotion scores were slightly significantly
different between intervention groups at the end of the
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