A Cochrane review [Abstract] 1 included 58 RCTs with a total of 2797 stroke patients. The mean age was 62 years. The mean time since onset of stroke ranged from 8.8 days to 7.7 years. Most of the included trials recruited participants during hospital or community stroke care and a total of 49 trials recruited ambulatory stroke survivors. Included trials evaluated comprised cardiorespiratory (28 trials, n=1408), resistance (13 trials, n=432), and mixed training interventions (17 trials, n=957). Thirteen deaths occurred before the end of the intervention and a further 9 at the end of follow-up. No dependence data were reported. Global indices of disability show a tendency to improve after cardiorespiratory training (SMD 0.52, 95% CI 0.19 to 0.84; 9 trials, n=462); benefits at follow-up and after mixed training were unclear. There were insufficient data to assess the effects of resistance training. Cardiorespiratory training involving walking improved maximum walking speed (MD 6.71 m/min, 95% CI 2.73 to 10.69; 14 trials, n=631), preferred gait speed (MD 4.28 m/min, 95% CI 1.71 to 6.84; 10 trials, n=505), walking capacity (MD 41.60 m/6 min, 95% CI 25.25 to 57.95 ; 7 trials, n=561), and balance scores (MD 0.27, 95% CI 0.07 to 0.47; 9 trials, n=596) at the end of the intervention. Some mobility benefits also persisted at the end of follow-up.
Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in patients, interventions and outcomes).
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