Effect of a Multicomponent Exercise Intervention on Recovery of Walking Ability in Stroke Survivors: A Systematic Review With Meta-analysis

Author: Songshuang Yan1, Xuemei Zhang2, Jing Zhang1, Juying Lu3, Qianfeng Que3, Lijuan Jiang3, Yan Sang3, Yawei Yu3, Xiaojuan Xu3, Chunfeng Xing3
Affiliation:
1 School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China.
2 Affiliated Hospital of Nantong University, Nantong, Jiangsu, China. Electronic address: 2557989983@qq.com.
3 Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.
Conference/Journal: Arch Phys Med Rehabil
Date published: 2025 Jan 1
Other: Volume ID: 106 , Issue ID: 1 , Pages: 124-133 , Special Notes: doi: 10.1016/j.apmr.2024.06.023. , Word Count: 281


Objective:
To evaluate whether multicomponent exercise (MCE) is more effective than single exercise in improving walking ability in patients with stroke.

Design:
A systematic review and meta-analysis.

Data sources:
A systematic search of PubMed, Embase, Web of Science, Cochrane Library, and CINAHL from the establishment of each database to February 2024 was performed. A combination of medical subject headings and free-text terms relating to stroke and exercise were searched.

Study selection:
Randomized controlled trials treating stroke survivors with MCE were included. The control groups received conventional treatments such as conventional treatment or no intervention or sham training; the experimental groups received MCE. The outcome measures were walking endurance, gait speed, and balance ability.

Data extraction:
The data extraction form was completed by 2 independent reviewers. The risk of bias was assessed using the Cochrane Risk of Bias Tool for randomized controlled trials. Review manager 5.4 software was used for data analysis. Subgroup analysis and sensitivity analysis were used to supplement the results with higher heterogeneity. The preferred reporting project for systematic reviews and meta-analyses 2020 guidelines were followed.

Data synthesis:
Twelve studies were included. Meta-analyses found that compared with the control group, the MCE significantly affected gait speed (mean difference=0.11; 95% CI, 0.06-0.16; I2=0%), but the effect on balance ability was not statistically significant. Subgroup analysis showed that MCE (≥60min) was effective in improving walking endurance. These results suggest that MCE improves walking endurance and walking speed in patients with stroke.

Conclusions:
MCE helps improve the gait speed of stroke survivors. Prolonging the MCE time may have a better effect on improving the walking endurance of patients with stroke.

Keywords: Balance; Combined training; Endurance; Gait speed; Multicomponent exercise; Rehabilitation; Stroke; Walking ability.

PMID: 39151746 DOI: 10.1016/j.apmr.2024.06.023

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