A systematic review of exercise trials post stroke

Objective: To perform a systematic review of exercise trials post stroke. Design: A systematic review of controlled clinical trials. Search strategy: MEDLINE, EMBASE, CINAHL, Amed, Sports Discus, Cochrane controlled trials register and PEDro were searched for relevant trials. Inclusion criteria: Studies - randomized or quasi-randomized controlled clinical trials. Participants - Adults of any age with a clinical diagnosis of stroke. Interventions - Any cardiovascular exercise intervention aimed at improving cardiovascular fitness and/or function. Outcomes: Impairment: gait speed, strength, endurance, balance, flexibility, tonus and exercise capacity. Disability: global dependency, functional independence. Extended activities of daily living. Quality of life. Death. Data collection and analysis: Two independent reviewers categorized selected trials, documented the methodological quality and extracted the relevant data. Comparisons of cardiovascular exercise interventions versus no cardiovascular intervention were made. Statistical comparisons were carried out using a random effects model to calculate standardized mean differences. Results: We identified three eligible trials. Small numbers and heterogeneous outcomes limited the analyses and comparisons. Based on the limited data available, we found that cardiovascular exercise post stroke was no better than no exercise with respect to disability, impairment, extended activities of daily living, quality of life and death. Conclusion: Insufficient evidence was identified to establish if cardiovascular exercise has a positive effect on disability, impairment, extended activities of daily living, quality of life and case fatality post stroke.