Effect of a multi-component exercise intervention on recovery of walking ability in stroke survivors: A Systematic Review with Meta-Analysis.

ABSTRACT

OBJECTIVE: To evaluate whether Multi-component exercise (MCE) is more effective than single exercise in improving walking ability in stroke patients. DESIGN: Systematic review and meta-analysis. DATA SOURCES A systematic search of PubMed, Embase, Web of Science, Cochrane Library, and CINAHL from the establishment of each database to February 2024 was performed. A combination of medical subject headings and free-text terms relating to stroke, exercise were searched. STUDY SELECTION Randomized controlled trials treating stroke survivors with multi-component exercise were included. The control groups received conventional treatments such as conventional treatment or no intervention or sham training; the experimental groups received multi-component exercise. The outcome measures were walking endurance, gait speed and balance ability. DATA EXTRACTION The data extraction form was completed by two independent reviewers.The risk of bias was assessed using the Cochrane Risk of Bias tool for randomized Controlled Trials.Review Manager 5.4 software was used for data analysis.Subgroup analysis and sensitivity analysis were used to supplement the results with higher heterogeneity.The Preferred Reporting Project for Systematic Reviews and Meta-analyses 2020 guidelines were followed. DATA SYNTHESIS: 12 studies were included. Meta-analyses found that compared with the control group,MCE significantly affected gait speed (MD = 0.11; 95%CI 0.06, 0.16, I2 = 0%), but the effect on balance ability was not statistically significant.Subgroup analysis showed that MCE (≥60 min) was effective in improving walking endurance. These results suggest that multi-component exercise improves walking endurance and walking speed in stroke patients. CONCLUSION: Multi-component exercise helps improve the gait speed of stroke survivors. Prolonging the multi-component exercise time may have a better effect on improving the walking endurance of stroke patients.