Yang Zixian, Qin Shaokun, Li Jiaxing, Li Cong, Lu Ye, He Pei, Liu Jia, Pei Lin
School of Basic Medicine, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China.
Section of Science and Education, The Second Affiliated Hospital of Hebei University of Chinese Medicine, Dingzhou, Hebei, China.
Front Neurol. 2025 Mar 24;16:1564347. doi: 10.3389/fneur.2025.1564347. eCollection 2025.
Stroke patients often experience sequelae such as depressive symptoms, cognitive impairment, and abnormal physical function. Exercise intervention may be an effective and safe non-drug treatment to address these health issues.
The aim of this meta-analytical review was to explore the effects of exercise intervention programs on depressive symptoms, cognitive function, physical function, and quality of life in stroke patients, as well as to identify appropriate exercise programs.
Seven databases were searched from the library's construction until 30 August 2024. A meta-analysis was performed, and the risk of bias was assessed using Review Manager 5.4. Sensitivity analysis was conducted using Stata 16.0 software, and the overall certainty of the evidence was rated using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methods.
A total of 11,607 studies were identified. Among these, 20 studies, which included 1,848 patients, were considered eligible for this network meta-analysis. Compared to the control group, exercise significantly improved cognitive function (standard mean difference [SMD] = 1.08, 95% confidence interval [CI] = 0.40-1.75, = 0.002), physical balance ability (mean difference [MD] = 0.80, 95% CI = 0.23-1.37, < 0.01), physical walking ability (MD = 48.39, 95% CI = 8.06-88.72, = 0.02), and quality of life. However, exercise had no significant effect on depressive symptoms (SMD = -0.2, 95% CI = -0.46-0.05, = 0.11). A subgroup analysis indicated that a longer duration of exercise (> 3 months) can effectively improve depressive symptoms in stroke patients.
The results indicated that cognitive function, balance, walking speed, and quality of life of stroke patients improved following exercise intervention, and longer exercise duration (> 3 months) contributed to alleviating the depressive symptoms of stroke patients. Therefore, we recommend that stroke patients engage in physical exercise 3 times a week for 1 h each session. The exercise duration should continue for at least 3 months to ensure the best therapeutic effect. Furthermore, determining exercise intensity should be a personalized process-carefully customized to align with the physical capabilities and limitations of each patient.
https://www.crd.york.ac.uk/prospero, CRD42024520778.
中风患者常伴有抑郁症状、认知障碍和身体功能异常等后遗症。运动干预可能是解决这些健康问题的一种有效且安全的非药物治疗方法。
本荟萃分析综述旨在探讨运动干预方案对中风患者抑郁症状、认知功能、身体功能和生活质量的影响，并确定合适的运动方案。
从图书馆建库至2024年8月30日检索了7个数据库。进行了荟萃分析，并使用Review Manager 5.4评估偏倚风险。使用Stata 16.0软件进行敏感性分析，并采用推荐分级、评估、制定与评价（GRADE）方法对证据的总体确定性进行评级。
共识别出11,607项研究。其中，20项研究（包括1,848名患者）被认为符合本网络荟萃分析的条件。与对照组相比，运动显著改善了认知功能（标准化均数差[SMD]=1.08，95%置信区间[CI]=0.40 - 1.75，P = 0.002）、身体平衡能力（均数差[MD]=0.80，95% CI = 0.23 - 1.37，P < 0.01）、身体行走能力（MD = 48.39，95% CI = 8.06 - 88.72，P = 0.02）和生活质量。然而，运动对抑郁症状无显著影响（SMD = -0.2，95% CI = -0.46 - 0.05，P = 0.11）。亚组分析表明，较长的运动持续时间（>3个月）可有效改善中风患者的抑郁症状。
结果表明，运动干预后中风患者的认知功能、平衡能力、行走速度和生活质量得到改善，较长的运动持续时间（>3个月）有助于减轻中风患者的抑郁症状。因此，我们建议中风患者每周进行3次体育锻炼，每次锻炼1小时。运动持续时间应至少持续3个月以确保最佳治疗效果。此外，确定运动强度应是一个个性化过程，要根据每个患者的身体能力和限制进行精心定制。
