Department of rehabilitation, Laval University, 1050, avenue de la Médecine, QC, G1V0A6 Quebec, Canada.
Centre for Interdisciplinary Research in Rehabilitation and Social Integration, 525, boulevard Wilfrid-Hamel, QC, G1M 2S8 Quebec City, Canada.
Ann Phys Rehabil Med. 2021 Jul;64(4):101443. doi: 10.1016/j.rehab.2020.09.007. Epub 2020 Oct 28.
Rehabilitation is a mandatory component of stroke management, aiming to recover functional capacity and independence. To that end, physical therapy sessions must involve adequate intensity in terms of cardiopulmonary stress to meet the physiological demands of independent living.
The aim of this systematic review was to determine the current level of cardiopulmonary strain during rehabilitation sessions in stroke patients.
Three electronic databases (PubMed, CINAHL and Embase. com) were searched to identify observational studies that documented cardiopulmonary strain during rehabilitation sessions in post-stroke patients (last search performed in February 2019). A manual cross-referencing search was also performed. To be included, articles needed to report data related to both cardiopulmonary strain (heart rate, oxygen consumption or energy expenditure) and active therapy time. The methodological quality of each study was assessed with the Evidence-Based Librarianship Critical Appraisal Tool. Data related to both cardiorespiratory strain and active therapy time were extracted from selected articles.
Four of 43 full-text articles assessed for eligibility met the inclusion criteria. Results extracted from these articles suggested that the intensity of rehabilitation sessions was insufficient to induce a cardiopulmonary training effect in a post-stroke context as measured by metabolic stress. Patients were inactive from 21% to 80% of the therapy time. The Evidence-Based Librarianship tool scores ranged from 65% (15/23) to 91% (21/23), which indicates questionable to good quality.
The current literature on cardiopulmonary solicitation during stroke rehabilitation sessions is poor in terms of both the number of studies available and their methodological quality. Summarized results tend to support previous claims that rehabilitation sessions offered to stroke patients are of suboptimal cardiopulmonary strain, which can interfere with their capacity to regain functional independence.
康复是卒中管理的强制性组成部分，旨在恢复功能能力和独立性。为此，物理治疗课程必须在心肺压力方面具有足够的强度，以满足独立生活的生理需求。
本系统评价旨在确定卒中患者康复过程中心肺压力的当前水平。
在 3 个电子数据库（PubMed、CINAHL 和 Embase.com）中搜索了描述卒中后患者康复过程中心肺压力的观察性研究（最后一次搜索于 2019 年 2 月进行）。还进行了手动交叉引用搜索。为了被纳入，文章需要报告与心肺压力（心率、耗氧量或能量消耗）和主动治疗时间相关的数据。使用循证图书馆学批判性评估工具评估了每项研究的方法学质量。从选定的文章中提取了与心肺压力和主动治疗时间相关的数据。
在评估合格性的 43 篇全文文章中，有 4 篇符合纳入标准。从这些文章中提取的结果表明，就代谢应激而言，康复课程的强度不足以在卒中背景下引起心肺训练效果。患者在治疗时间的 21%至 80%期间处于非活动状态。循证图书馆学工具评分范围为 65%（15/23）至 91%（21/23），表明质量有问题或良好。
就现有研究数量和方法学质量而言，当前关于卒中康复过程中心肺刺激的文献都很差。总结结果倾向于支持先前的观点，即提供给卒中患者的康复课程的心肺压力不足，这会干扰他们恢复功能独立性的能力。
