Center of Health Sciences, Discipline of Physiotherapy, Universidade Federal do Espírito Santo, Brazil; NeuroGroup, Discipline of Physiotherapy, Universidade Federal de Minas Gerais, Brazil.
Center of Health Sciences, Discipline of Physiotherapy, Universidade Federal do Espírito Santo, Brazil.
Physiotherapy. 2020 Jun;107:100-110. doi: 10.1016/j.physio.2019.10.002. Epub 2019 Oct 21.
Water-based exercises have the potential to reduce impairments and walking limitations after stroke.
To examine the effects of water-based exercises on walking speed, balance, and strength after stroke.
Eletronic searches on MEDLINE, CINAHL, EMBASE, Cochrane, PsycINFO, and PEDro databases.
The review included randomized trials. Participants in the reviewed studies were ambulatory adults, who have had a stroke. The experimental intervention was comprised of water-based exercises.
Outcome data related to walking speed, balance, and strength were extracted from the eligible trials and combined in meta-analyses. The quality of the included trials was assessed by the PEDro scores and the quality of evidence was determined according to the Grading of Recommendations Assessment, Development, and Evaluation system.
Thirteen trials involving 464 participants were included. Random-effects meta-analyses provided moderate-quality evidence that water-based exercises significantly increase walking speed by 0.06m/second (95% CI 0.01 to 0.10) and balance by 4.5 points on the Berg Balance scale (95% CI 2.2 to 6.8), compared with land-based exercises, without concurrent changes in strength (MD 5.2Nm/kg; 95% CI -1.4 to 11.9).
This systematic review provided low-quality evidence regarding the efficacy of water-based exercises, compared with no intervention. However, there is moderate quality evidence, which suggested significant benefits of water-based exercises in walking speed and balance, compared with land-based exercises. Differences appear small to be considered clinically relevant, and, therefore, water-based exercises can be prescribed as alternative interventions, based upon individuals' exercise preferences. Systematic Review Registration Number PROSPERO (CRD42018108419).
水基运动有可能减少中风后的身体损伤和步行障碍。
研究水基运动对中风后步行速度、平衡和力量的影响。
对 MEDLINE、CINAHL、EMBASE、Cochrane、PsycINFO 和 PEDro 数据库进行电子检索。
综述纳入了随机试验。综述中研究的参与者为有步行能力的成年人，曾患有中风。实验干预包括水基运动。
从合格试验中提取与步行速度、平衡和力量相关的结局数据，并进行荟萃分析。通过 PEDro 评分评估纳入试验的质量，根据推荐评估、制定与评估系统（Grading of Recommendations Assessment, Development, and Evaluation system）确定证据质量。
纳入了 13 项涉及 464 名参与者的试验。随机效应荟萃分析提供了中等质量的证据，表明与陆地运动相比，水基运动可使步行速度显著提高 0.06m/秒（95%CI 0.01 至 0.10），Berg 平衡量表评分提高 4.5 分（95%CI 2.2 至 6.8），而力量无变化（MD 5.2Nm/kg；95%CI -1.4 至 11.9）。
与无干预相比，本系统评价提供了水基运动疗效的低质量证据。然而，与陆地运动相比，水基运动在步行速度和平衡方面具有中等质量的证据，表明其具有显著优势。差异小，认为无临床意义，因此，水基运动可以根据个人的运动偏好作为替代干预措施进行处方。系统评价注册号 PROSPERO（CRD42018108419）。
