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

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T A B L E O F C O N T E N T S HEADER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 ABSTRACT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 PLAIN LANGUAGE SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 BACKGROUND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 OBJECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 METHODS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 RESULTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Figure 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Figure 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 DISCUSSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 AUTHORS’ CONCLUSIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 ACKNOWLEDGEMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 CHARACTERISTICS OF STUDIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 DATA AND ANALYSES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 Analysis 1.1. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 1 Disability - Functional Independence Measure. . . . . . . . . . . . . . . . . . . . . . . . . . . 101 Analysis 1.2. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 2 Disability - Rivermead Mobility Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102 Analysis 1.3. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 3 Disability - Physical Activity and Disability Scale. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 Analysis 1.4. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 4 Risk factors - blood pressure, systolic. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 Analysis 1.5. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 5 Risk factors - blood pressure, diastolic. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105 Analysis 1.6. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 6 Physical fitness - peak VO2 (ml/kg/min). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106 Analysis 1.7. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 7 Physical fitness - gait economy, VO2 (ml/kg/metre). . . . . . . . . . . . . . . . . . . . . . . . . . . 107 Analysis 1.8. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 8 Physical fitness - maximum cycling work rate (Watts). . . . . . . . . . . . . . . . . . . . . . . . . . . 108 Analysis 1.9. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 9 Physical fitness - Body Mass (Kg). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 Analysis 1.10. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 10 Mobility - functional ambulation categories. . . . . . . . . . . . . . . . . . . . . . . . . . . . 110 Analysis 1.11. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 11 Mobility - maximal gait speed (m/min over 5 to 10 metres). . . . . . . . . . . . . . . . . . . . . . . 111 Analysis 1.12. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 12 Mobility - maximal gait speed (m/min over 5 to 10 metres); subgroup: ACSM. . . . . . . . . . . . . . . . 112 Analysis 1.13. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 13 Mobility - preferred gait speed (m/min). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 Analysis 1.14. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 14 Mobility - gait endurance (6-MWT metres). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114 Analysis 1.15. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 15 Mobility - gait endurance (m/min). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 Analysis 1.16. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 16 Mobility - 6metre walking time (sec). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116 Analysis 1.17. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 17 Mobility - Stroke Impact Scale (mobility domain). . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Analysis 1.18. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 18 Mobility - peak activity index (steps/min). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118 Physical fitness training for stroke patients (Review) Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. i
Analysis 1.19. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 19 Mobility - max step rate in 1 min. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 Analysis 1.20. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 20 Physical function - Berg Balance scale. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 Analysis 1.21. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 21 Physical function - Timed Up and Go (sec). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121 Analysis 1.22. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 22 Health related QoL - SF-36 physical functioning. . . . . . . . . . . . . . . . . . . . . . . . . . . 122 Analysis 1.23. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 23 Health related QoL - SF-36 emotional role functioning. . . . . . . . . . . . . . . . . . . . . . . . . 123 Analysis 1.24. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 24 Mood - Beck Depression Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 Analysis 1.25. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 25 Mood - Hospital Anxiety and Depression Scale (HADS) - anxiety score. . . . . . . . . . . . . . . . . . . . . 125 Analysis 1.26. Comparison 1 Cardiorespiratory training versus control - end of intervention, Outcome 26 Mood - Hospital Anxiety and Depression Scale (HADS) - depression score. . . . . . . . . . . . . . . . . . . 126 Analysis 2.1. Comparison 2 Cardiorespiratory training versus control - end of retention follow-up, Outcome 1 Case fatality. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126 Analysis 2.2. Comparison 2 Cardiorespiratory training versus control - end of retention follow-up, Outcome 2 Disability - Rivermead Mobility Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 Analysis 2.3. Comparison 2 Cardiorespiratory training versus control - end of retention follow-up, Outcome 3 Disability - Nottinghan Extended ADLs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128 Analysis 2.4. Comparison 2 Cardiorespiratory training versus control - end of retention follow-up, Outcome 4 Disability - Physical Activity and Disability Scale. . . . . . . . . . . . . . . . . . . . . . . . . . 129 Analysis 2.5. Comparison 2 Cardiorespiratory training versus control - end of retention follow-up, Outcome 5 Disability - Frenchay Activities Index (FAI). . . . . . . . . . . . . . . . . . . . . . . . . . . . 130 Analysis 2.6. Comparison 2 Cardiorespiratory training versus control - end of retention follow-up, Outcome 6 Physical fitness - maximum cycling work rate (Watts). . . . . . . . . . . . . . . . . . . . . . . . 131 Analysis 2.7. Comparison 2 Cardiorespiratory training versus control - end of retention follow-up, Outcome 7 Physical fitness - maximum cycling work rate (Watts) - ITT analysis using ’last observation carried forward’ approach. . 132 Analysis 2.8. Comparison 2 Cardiorespiratory training versus control - end of retention follow-up, Outcome 8 Physical fitness - Body Mass (Kg). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 Analysis 2.9. Comparison 2 Cardiorespiratory training versus control - end of retention follow-up, Outcome 9 Mobility - maximal gait speed (m/min). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134 Analysis 2.10. Comparison 2 Cardiorespiratory training versus control - end of retention follow-up, Outcome 10 Mobility - gait endurance (6-MWT metres). . . . . . . . . . . . . . . . . . . . . . . . . . . 135 Analysis 2.11. Comparison 2 Cardiorespiratory training versus control - end of retention follow-up, Outcome 11 Mobility - peak activity index (steps/min). . . . . . . . . . . . . . . . . . . . . . . . . . . . 136 Analysis 2.12. Comparison 2 Cardiorespiratory training versus control - end of retention follow-up, Outcome 12 Mobility - max step rate in 1 min. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Analysis 2.13. Comparison 2 Cardiorespiratory training versus control - end of retention follow-up, Outcome 13 Mobility - Stroke Impact Scale (mobility domain). . . . . . . . . . . . . . . . . . . . . . . . . 138 Analysis 2.14. Comparison 2 Cardiorespiratory training versus control - end of retention follow-up, Outcome 14 Physical function - Berg Balance scale. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 Analysis 2.15. Comparison 2 Cardiorespiratory training versus control - end of retention follow-up, Outcome 15 Physical function - Berg Balance scale - ITT analysis using ’last observation carried forward’ approach. . . . . . . 140 Analysis 2.16. Comparison 2 Cardiorespiratory training versus control - end of retention follow-up, Outcome 16 Mood - Beck Depression Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 Analysis 2.17. Comparison 2 Cardiorespiratory training versus control - end of retention follow-up, Outcome 17 Mood - Hospital Anxiety and Depression Scale (HADS) - anxiety score. . . . . . . . . . . . . . . . . 142 Analysis 2.18. Comparison 2 Cardiorespiratory training versus control - end of retention follow-up, Outcome 18 Mood - Hospital Anxiety and Depression Scale (HADS) - depression score. . . . . . . . . . . . . . . . 143 Physical fitness training for stroke patients (Review) Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. ii
Page 1: Physical fitness training for strok
Page 5 and 6: Analysis 5.10. Comparison 5 Mixed t
Page 7 and 8: Analysis 7.2. Comparison 7 Cardiore
Page 9 and 10: walking speed (mean difference (MD)
Page 11 and 12: Post-stroke physical activity and f
Page 13 and 14: Search methods for identification o
Page 15 and 16: • type of training (cardiorespira
Page 17 and 18: Compliance with the scheduled exerc
Page 19 and 20: Case fatality Number of deaths was
Page 21 and 22: we did not include these data in th
Page 23 and 24: (Flansbjer 2008; Kim 2001; Ouellett
Page 25 and 26: data were, however, confounded by a
Page 27 and 28: Vascular risk factors A few trials
Page 29 and 30: ical function outcomes did not impr
Page 31 and 32: We thank the Cochrane Stroke Group
Page 33 and 34: or relaxation. Proceedings of the U
Page 35 and 36: Dean 1997 {published data only} Dea
Page 37 and 38: (LEAPS): a randomized controlled tr
Page 39 and 40: with chronic stroke. Neurorehabilit
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Page 45 and 46: andomized controlled trials. Clinic
Page 47 and 48: Bale 2008 Methods Design: randomise
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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 1.2. Comparison 1 Cardiore
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Table 1. Outline of the studies whi
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Table 3. Outline of the studies whi
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Table 4. Pooled walking data for ca
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#42.(physical in Abstract and (exer
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71 8 and 36 and 70 72 limit 71 to h
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S58. (MH “Random Assignment”) o
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W H A T ’ S N E W Last assessed a
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MeSH check words Humans Physical fi
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