Nindorera Felix, Leveque Clement, Meyer Eric, Balestra Costantino, Theunissen Sigrid
Environmental, Occupational, Aging (Integrative) Physiology Laboratory, Department of Physiotherapy, Haute Ecole Bruxelles-Brabant (HE2B), Brussels, Belgium; Centre for interdisciplinary research in rehabilitation and social integration, Centre intégré universitaire de Santé et de services sociaux de la Capitale-Nationale, Québec, Canada.
Environmental, Occupational, Aging (Integrative) Physiology Laboratory, Department of Physiotherapy, Haute Ecole Bruxelles-Brabant (HE2B), Brussels, Belgium.
J Rehabil Med. 2025 Aug 11;57:jrm43359. doi: 10.2340/jrm.v57.43359.
To evaluate the effects of different exercise training modalities on maximal and sub-maximal physical fitness in chronic stroke patients and determine the optimal training dosage.
Systematic review and meta-analysis of 38 randomized controlled trials.
A comprehensive search was conducted across seven databases (MedLine, Embase, ScienceDirect, Cochrane Library, CINAHL, and SPORTSDiscus) up to March 31, 2024. Maximal fitness was measured by VO2 max/peak, and sub-maximal fitness by the 6- or 12-minute walk test (6MWT) Results: Aerobic and mixed training significantly improved VO2 max/peak (MD = 3.16 [2.83, 3.49], p < 0.00001; I² = 22%). Only aerobic training significantly enhanced 6MWT performance (MD = 34.30 [25.08, 43.53], p < 0.00001; I² = 25%). Sensitivity analysis revealed that VO2 max/peak gains were greater with moderate-to-high intensity, while moderate intensity sufficed for 6MWT improvement. The optimal regimen was 45-minute sessions of moderate-to-high intensity aerobic training, at least three times weekly for a minimum of eight weeks.
Moderate-to-vigorous aerobic training enhances physical fitness in chronic stroke. High-intensity and mixed training programs yield greater maximal fitness improvements, while moderate intensity benefits sub-maximal capacity. Targeted, intensity-monitored exercise programs of ≥45 minutes, three times weekly over ≥8 weeks, are recommended for significant fitness gains.
评估不同运动训练方式对慢性卒中患者最大和次最大体能的影响，并确定最佳训练剂量。
对38项随机对照试验进行系统评价和荟萃分析。
截至2024年3月31日，在七个数据库（MedLine、Embase、ScienceDirect、Cochrane图书馆、CINAHL和SPORTSDiscus）中进行了全面检索。最大体能通过最大摄氧量/峰值来衡量，次最大体能通过6分钟或12分钟步行试验（6MWT）来衡量。结果：有氧训练和混合训练显著提高了最大摄氧量/峰值（MD = 3.16 [2.83, 3.49]，p < 0.00001；I² = 22%）。只有有氧训练显著提高了6MWT表现（MD = 34.30 [25.08, 43.53]，p < 0.00001；I² = 25%）。敏感性分析显示，中高强度训练时最大摄氧量/峰值的增加更大，而中等强度就足以改善6MWT。最佳方案是每周至少三次、每次45分钟的中高强度有氧训练，持续至少八周。
中等到剧烈的有氧训练可增强慢性卒中患者的体能。高强度和混合训练方案能使最大体能得到更大改善，而中等强度有益于次最大体能。建议进行有针对性的、强度监测的运动方案，每次训练≥45分钟，每周三次，持续≥8周，以显著提高体能。
