The impact of increased duration of exercise therapy on functional recovery following stroke—what is the evidence?
This article focuses on the impact of increased duration of exercise therapy on functional
recovery after stroke. A comprehensive literature search using multiple databases was used
to identify all relevant randomized controlled trials. Their quality was reviewed by two
independent assessors, and a narrative systematic review and meta-analysis was
completed. Methodological quality of all the 20 randomized controlled trials (RCTs)
identified had a median of 6 points (range 5–8) on the 10-point PEDro scale. A meta …
recovery after stroke. A comprehensive literature search using multiple databases was used
to identify all relevant randomized controlled trials. Their quality was reviewed by two
independent assessors, and a narrative systematic review and meta-analysis was
completed. Methodological quality of all the 20 randomized controlled trials (RCTs)
identified had a median of 6 points (range 5–8) on the 10-point PEDro scale. A meta …
Abstract
This article focuses on the impact of increased duration of exercise therapy on functional recovery after stroke. A comprehensive literature search using multiple databases was used to identify all relevant randomized controlled trials. Their quality was reviewed by two independent assessors, and a narrative systematic review and meta-analysis was completed. Methodological quality of all the 20 randomized controlled trials (RCTs) identified had a median of 6 points (range 5–8) on the 10-point PEDro scale. A meta-analysis was completed for studies that had a common outcome measure. For each outcome measure, the estimated effect size (ES) and the summary effect size (SES) were expressed as standardized mean differences (SMD). The results of the meta-analysis demonstrated that increased duration of exercise therapy time has a small but positive effect on activities of daily living as measured by the Barthel Index (SES 0.13; CI 0.01–0.25; Z = 2.15; p = .03) and that these improvements are maintained over a 6-month period (SES 0.15; CI 0.05–0.26; Z = 2.8; p = .00). Pooling reported differences in the various upper and lower extremity outcome measures demonstrated no significant SESs. However, the meta-analysis is supportive of the hypothesis that additional, focused exercise on the lower extremity has a favourable effect on lower extremity impairment and walking speed. The narrative review raises a number of issues that need to be considered in the development of future RCTs.
Taylor & Francis Online
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