Impact of Active Physiotherapy on Physical Activity Level 1 in Stroke Survivors: a Systematic Review and Meta-Analysis

Background: Stroke survivors are frequently physically inactive. However, evidence of the effectiveness of active physiotherapy on physical activity level in stroke survivors is scarce. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) according to th...

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Bibliographic Details
Published inStroke (1970)
Main Author Duclos, Stéphanie Goncalves Morgane Le Bourvellec Stéphane Mandigout Noémie
Format Journal Article
LanguageEnglish
Published American Heart Association 2023
Subjects
Life Sciences
Stroke
Exercise
Physiotherapy
Physical Activity Level
Rehabilitation
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Summary:Background: Stroke survivors are frequently physically inactive. However, evidence of the effectiveness of active physiotherapy on physical activity level in stroke survivors is scarce. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) according to the PRISMA statement, covering electronic searches from inception to March 16, 2022. Participants: Stroke survivors living in the community. Intervention: Any active physiotherapy, i.e., involving exercises that require voluntary effort. Outcome measure: Objective and subjective physical activity level. Results: Of 5590 identified references, 25 RCTs were eligible, and 21 had available data. The random-effects meta-analysis resulted in a small, significant effect size in favour of active physiotherapy measured using objective or subjective tools (21 studies, 1834 participants, standardized mean difference (SMD) 0.22, 95% confidence interval (CI) 0.04 to 0.40, heterogeneity I2=65%), and a medium significant effect when objective tools were used (9 studies, 424 participants, SMD 0.48, 95% CI 0.03 to 0.92 I2=73%). Meta-regression showed that 35% of the variance in trial outcome was explained by the measurement tool (objective or subjective) and 23% by age. None of the variances were associated with a specific dosage in terms of frequency, time, or exercise duration, or with the severity of the disability. Conclusion: Active physiotherapy seems to increase objective physical activity in community-dwelling stroke survivors. However, the evidence is of very low certainty.Registration PROPERO CRD42022315639
ISSN:0039-2499
1524-4628