Moneruzzaman Md, Tang Zhiqing, Li Xiaohe, Sun Weizhen, Maduray Kellina, Luo Meiling, Kader Manzur, Wang Yonghui, Zhang Hao
School of Rehabilitation, Capital Medical University, Beijing, China.
Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China.
Front Cardiovasc Med. 2025 Mar 24;12:1457899. doi: 10.3389/fcvm.2025.1457899. eCollection 2025.
This systematic review aimed to evaluate the impact of post-stroke exercise-based rehabilitation programs on blood pressure, lipid profile, and exercise capacity.
Through a systemic search of literature from inception to 2024 using five databases, we analyzed data on the mean difference (MD) using a meta-analysis method to estimate effectiveness.
Thirty-seven randomized control trials were included encompassing various exercises such as aerobic, resistance, stretching, exergaming, robot-assisted training, and community-based training. Significant improvement was illustrated at discharge in systolic [MD 2.76 mmHg; 95% confidence interval (CI) -1.58 to 3.92, < 0.05] and diastolic (MD 1.28 mmHg; 95% CI 0.54-2.12, < 0.05) blood pressure and peak oxygen volume (MD -0.29 ml/kg/min; 95% CI -0.53 to 0.05, < 0.05). We also observed significant improvement at discharge in high-density lipoprotein only after resistance exercise from two articles and low-density lipoprotein only in the intervention groups compared to the control groups from ten articles.
Overall, current exercise-based rehabilitation programs significantly improve blood pressure and exercise capacity in patients with stroke at discharge. However, lipoprotein changes remained inconclusive. Although ameliorative changes were noted in most variables, more research is needed to determine optimum exercise intensity, type combination, and health education to reduce post-stroke complications and mortality.
本系统评价旨在评估基于运动的中风后康复计划对血压、血脂谱和运动能力的影响。
通过使用五个数据库对从创刊到2024年的文献进行系统检索，我们采用荟萃分析方法分析平均差（MD）数据以估计有效性。
纳入了37项随机对照试验，涵盖有氧运动、抗阻运动、伸展运动、电子游戏运动、机器人辅助训练和社区训练等各种运动。出院时收缩压[MD 2.76 mmHg；95%置信区间（CI）-1.58至3.92，P<0.05]、舒张压（MD 1.28 mmHg；95%CI 0.54 - 2.12，P<0.05）和峰值氧含量（MD -0.29 ml/kg/min；95%CI -0.53至0.05，P<0.05）有显著改善。我们还观察到，两篇文章显示抗阻运动后高密度脂蛋白在出院时有显著改善，十篇文章显示干预组与对照组相比低密度脂蛋白在出院时有显著改善。
总体而言，目前基于运动的康复计划在出院时能显著改善中风患者的血压和运动能力。然而，脂蛋白变化仍不明确。尽管大多数变量有改善变化，但仍需要更多研究来确定最佳运动强度、类型组合和健康教育，以减少中风后并发症和死亡率。
