School of Physiotherapy, Dalhousie University, 5869 University Avenue, Halifax, NS B3H 3J5, Canada; and Department of Physical Medicine and Rehabilitation, QEII Health Sciences Centre, Halifax, Nova Scotia, Canada.
Physical Therapy and Rehab Science, University of Kansas Medical Center, Kansas City, Kansas.
Phys Ther. 2020 Jan 23;100(1):149-156. doi: 10.1093/ptj/pzz153.
Most stroke survivors have very low levels of cardiovascular fitness, which limits mobility and leads to further physical deconditioning, increased sedentary behavior, and heightened risk of recurrent stroke. Although clinical guidelines recommend that aerobic exercise be a part of routine stroke rehabilitation, clinical uptake has been suboptimal. In 2013, an international group of stroke rehabilitation experts developed a user-friendly set of recommendations to guide screening and prescription-the Aerobic Exercise Recommendations to Optimize Best Practices in Care after Stroke (AEROBICS 2013). The objective of this project was to update AEROBICS 2013 using the highest quality of evidence currently available. The first step was to conduct a comprehensive review of literature from 2012 to 2018 related to aerobic exercise poststroke. A working group of the original consensus panel members drafted revisions based on synthesis. An iterative process was used to achieve agreement among all panel members. Final revisions included: (1) addition of 115 new references to replace or augment those in the original AEROBICS document, (2) rewording of the original recommendations and supporting material, and (3) addition of 2 new recommendations regarding prescription. The quality of evidence from which these recommendations were derived ranged from low to high. The AEROBICS 2019 Update should make it easier for clinicians to screen for, and prescribe, aerobic exercise in stroke rehabilitation. Clinical implementation will not only help to narrow the gap between evidence and practice but also reduce current variability and uncertainty regarding the role of aerobic exercise in recovery after stroke.
大多数中风幸存者的心血管健康水平非常低，这限制了他们的活动能力，导致进一步的身体适应不良、久坐行为增加以及中风复发的风险增加。尽管临床指南建议有氧运动是中风康复常规的一部分，但临床应用一直不尽如人意。2013 年，一组国际中风康复专家制定了一套易于使用的建议，以指导筛查和处方-《中风后优化最佳护理实践的有氧运动建议》（AEROBICS 2013）。该项目的目的是使用当前可用的最高质量证据更新 AEROBICS 2013。第一步是对 2012 年至 2018 年与中风后有氧运动相关的文献进行全面审查。最初的共识小组成员工作组根据综合结果起草了修订版。使用迭代过程在所有小组成员之间达成一致。最终修订包括：（1）添加了 115 篇新参考文献，以取代或补充原始 AEROBICS 文件中的参考文献，（2）重新措辞原始建议和支持材料，以及（3）添加了 2 条关于处方的新建议。这些建议所依据的证据质量从低到高不等。AEROBICS 2019 更新应该使临床医生更容易对中风康复患者进行筛查和开处有氧运动处方。临床实施不仅有助于缩小证据与实践之间的差距，还可以减少目前关于有氧运动在中风后康复中作用的可变性和不确定性。
