Noguchi Kenneth S, Moncion Kevin, Wiley Elise, Morgan Ashley, Huynh Eric, Balbim Guilherme Moraes, Elliott Brad, Harris-Blake Carlene, Krysa Brent, Koetsier Barb, Pinili Karolyn, Beauchamp Marla K, Phillips Stuart M, Thabane Lehana, Tang Ada
School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.
Br J Sports Med. 2025 Feb 3;59(3):185-197. doi: 10.1136/bjsports-2024-108476.
To examine the effects of strength training on patient-important outcomes of stroke recovery and to quantify the influence of the exercise prescription on treatment effects.
Systematic review and meta-analysis.
Eight electronic databases (MEDLINE, EMBASE, EMCARE, AMED, PsycINFO, CINAHL, SPORTDiscus, and Web of Science) and two clinical trial registries (ClinicalTrials.gov and WHO International Clinical Trials Registry Platform) were searched from inception to 19 June 2024.
Randomised controlled trials were eligible if they examined the effects of strength training compared with no exercise or usual care and reported at least one exercise prescription parameter. An advisory group of community members with lived experience of stroke helped inform outcomes most relevant to stroke recovery.
Forty-two randomised trials (N=2204) were included. Overall risk of bias was high across most outcomes. Strength training improved outcomes rated as 'critical for decision-making' by the advisory group, including walking capacity (standardised mean difference (SMD)=0.95 (95% CI 0.34-1.56)), balance (SMD=1.13 (0.51-1.75)), functional ability and mobility (SMD=0.61 (0.09-1.14)), and habitual (mean difference (MD)=0.05 m/s (0.02-0.09)) and fast-paced walking speed (MD=0.09 m/s (0.01-0.17)), with very low to moderate certainty of evidence, mainly due to risk of bias and inconsistency. More frequent strength training, traditional strength training programmes and power-focused intensities (ie, emphasis on movement velocity) were positively associated with walking capacity, health-related quality of life and fast-paced walking speed.
Strength training alone or combined with usual care improves stroke recovery outcomes that are important for decision-making. More frequent strength training, power-focused intensities and traditional programme designs may best support stroke recovery.
CRD42023414077.
研究力量训练对中风康复中患者重要结局的影响，并量化运动处方对治疗效果的影响。
系统评价和荟萃分析。
检索了8个电子数据库（MEDLINE、EMBASE、EMCARE、AMED、PsycINFO、CINAHL、SPORTDiscus和Web of Science）以及两个临床试验注册库（ClinicalTrials.gov和世界卫生组织国际临床试验注册平台），检索时间从创建至2024年6月19日。
如果随机对照试验研究了力量训练与不运动或常规护理相比的效果，并报告了至少一项运动处方参数，则该试验符合纳入标准。一个有中风生活经历的社区成员咨询小组协助确定了与中风康复最相关的结局。
纳入了42项随机试验（N = 2204）。大多数结局的总体偏倚风险较高。力量训练改善了咨询小组评定为“对决策至关重要”的结局，包括步行能力（标准化均数差（SMD）= 0.95（95%CI 0.34 - 1.56））、平衡能力（SMD = 1.13（0.51 - 1.75））、功能能力和活动能力（SMD = 0.61（0.09 - 1.14）），以及习惯性（均数差（MD）= 0.05 m/s（0.02 - 0.09））和快节奏步行速度（MD = 0.09 m/s（0.01 - 0.17）），证据确定性为极低至中等，主要是由于偏倚风险和不一致性。更频繁的力量训练、传统力量训练计划和以功率为重点的强度（即强调运动速度）与步行能力、健康相关生活质量和快节奏步行速度呈正相关。
单独进行力量训练或与常规护理相结合可改善对决策重要的中风康复结局。更频繁的力量训练、以功率为重点的强度和传统的计划设计可能最有助于中风康复。
PROSPERO注册号：CRD42023414077。
