Exercise dosage to facilitate the recovery of balance, walking, and quality of life after stroke

Background: Although aerobic training (AT) and resistance training (RT) are recommended after stroke, the optimal dosage of these interventions and their effectiveness on balance, walking capacity, and quality of life (QoL) remain conflicting. Objective: Our study aimed to quantify the effects of d...

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Main Authors: Elogni R. Amanzonwé, Lisa Tedesco Triccas, Léopold Codjo, Dominique Hansen, Peter Feys, Oyéné Kossi
Format: Article
Language:English
Published: AOSIS 2023-02-01
Series:South African Journal of Physiotherapy
Subjects:
Online Access:https://sajp.co.za/index.php/sajp/article/view/1846
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author Elogni R. Amanzonwé
Lisa Tedesco Triccas
Léopold Codjo
Dominique Hansen
Peter Feys
Oyéné Kossi
author_facet Elogni R. Amanzonwé
Lisa Tedesco Triccas
Léopold Codjo
Dominique Hansen
Peter Feys
Oyéné Kossi
author_sort Elogni R. Amanzonwé
collection DOAJ
description Background: Although aerobic training (AT) and resistance training (RT) are recommended after stroke, the optimal dosage of these interventions and their effectiveness on balance, walking capacity, and quality of life (QoL) remain conflicting. Objective: Our study aimed to quantify the effects of different modes, dosages and settings of exercise therapy on balance, walking capacity, and QoL in stroke survivors. Methods: PubMed, CINHAL, and Hinari databases were searched for randomised controlled trials (RCTs) evaluating the effects of AT and RT on balance, walking, and QoL in stroke survivors. The treatment effect was computed by the standard mean differences (SMDs). Results: Twenty-eight trials (n = 1571 participants) were included. Aerobic training and RT interventions were ineffective on balance. Aerobic training interventions were the most effective in improving walking capacity (SMD = 0.37 [0.02, 0.71], p = 0.04). For walking, capacity, a higher dosage (duration ≥ 120 min/week; intensity ≥ 60% heart rate reserve) of AT interventions demonstrated a significantly greater effect (SMD = 0.58 [0.12, 1.04], p = 0.01). Combined AT and RT improved QoL (SMD = 0.56 [0.12, 0.98], p = 0.01). Hospital located rehabilitation setting was effective for improving walking capacity (SMD = 0.57 [0.06, 1.09], p = 0.03) compared with home and/or community and laboratory settings. Conclusions: Our findings showed that neither AT nor RT have a significant effect on balance. However, AT executed in hospital-located settings with a higher dose is a more effective strategy to facilitate walking capacity in chronic stroke. In contrast, combined AT and RT is beneficial for improving QoL. Clinical implications: A high dosage of aerobic exercise, duration ≥ 120 min/week; intensity ≥ 60% heart rate reserve is beneficial for improving walking capacity.
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spelling doaj.art-40662e33804244e985d22658f6ba76bc2023-03-02T11:57:54ZengAOSISSouth African Journal of Physiotherapy0379-61752410-82192023-02-01791e1e1210.4102/sajp.v79i1.18461520Exercise dosage to facilitate the recovery of balance, walking, and quality of life after strokeElogni R. Amanzonwé0Lisa Tedesco Triccas1Léopold Codjo2Dominique Hansen3Peter Feys4Oyéné Kossi5Unit of NeuroRehabilitation, Department of Neurology NeuroRehabilitation, University of Parakou, Parakou, Benin; and, REVAL, Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, HasseltREVAL, Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, HasseltDepartment of Cardiology, Faculty of Medicine, University of Parakou, ParakouREVAL, Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; and, Heart Centre Hasselt, Jessa Hospital, HasseltREVAL, Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, HasseltREVAL, Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; and, Unit of NeuroRehabilitation, Department of Neurology NeuroRehabilitation, University Hospital of Parakou, Parakou, Benin; and, ENATSE, National School of Public Health and Epidemiology, University of Parakou, ParakouBackground: Although aerobic training (AT) and resistance training (RT) are recommended after stroke, the optimal dosage of these interventions and their effectiveness on balance, walking capacity, and quality of life (QoL) remain conflicting. Objective: Our study aimed to quantify the effects of different modes, dosages and settings of exercise therapy on balance, walking capacity, and QoL in stroke survivors. Methods: PubMed, CINHAL, and Hinari databases were searched for randomised controlled trials (RCTs) evaluating the effects of AT and RT on balance, walking, and QoL in stroke survivors. The treatment effect was computed by the standard mean differences (SMDs). Results: Twenty-eight trials (n = 1571 participants) were included. Aerobic training and RT interventions were ineffective on balance. Aerobic training interventions were the most effective in improving walking capacity (SMD = 0.37 [0.02, 0.71], p = 0.04). For walking, capacity, a higher dosage (duration ≥ 120 min/week; intensity ≥ 60% heart rate reserve) of AT interventions demonstrated a significantly greater effect (SMD = 0.58 [0.12, 1.04], p = 0.01). Combined AT and RT improved QoL (SMD = 0.56 [0.12, 0.98], p = 0.01). Hospital located rehabilitation setting was effective for improving walking capacity (SMD = 0.57 [0.06, 1.09], p = 0.03) compared with home and/or community and laboratory settings. Conclusions: Our findings showed that neither AT nor RT have a significant effect on balance. However, AT executed in hospital-located settings with a higher dose is a more effective strategy to facilitate walking capacity in chronic stroke. In contrast, combined AT and RT is beneficial for improving QoL. Clinical implications: A high dosage of aerobic exercise, duration ≥ 120 min/week; intensity ≥ 60% heart rate reserve is beneficial for improving walking capacity.https://sajp.co.za/index.php/sajp/article/view/1846balanceexercise therapyquality of lifestrokewalking ability
spellingShingle Elogni R. Amanzonwé
Lisa Tedesco Triccas
Léopold Codjo
Dominique Hansen
Peter Feys
Oyéné Kossi
Exercise dosage to facilitate the recovery of balance, walking, and quality of life after stroke
South African Journal of Physiotherapy
balance
exercise therapy
quality of life
stroke
walking ability
title Exercise dosage to facilitate the recovery of balance, walking, and quality of life after stroke
title_full Exercise dosage to facilitate the recovery of balance, walking, and quality of life after stroke
title_fullStr Exercise dosage to facilitate the recovery of balance, walking, and quality of life after stroke
title_full_unstemmed Exercise dosage to facilitate the recovery of balance, walking, and quality of life after stroke
title_short Exercise dosage to facilitate the recovery of balance, walking, and quality of life after stroke
title_sort exercise dosage to facilitate the recovery of balance walking and quality of life after stroke
topic balance
exercise therapy
quality of life
stroke
walking ability
url https://sajp.co.za/index.php/sajp/article/view/1846
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