目的:评估多成分运动(MCE)在改善中风患者的步行能力方面是否比单一运动更有效。
方法:系统评价和荟萃分析。
方法:对PubMed的系统搜索,Embase,WebofScience,科克伦图书馆,从每个数据库建立到2024年2月进行了CINAHL。医学主题词和与中风有关的自由文本术语的组合,练习被搜索。
方法:纳入多成分运动治疗卒中幸存者的随机对照试验。对照组接受常规治疗,如常规治疗或不干预或假训练;实验组接受多组分运动。结果指标是行走耐力,步态速度和平衡能力。
方法:数据提取表由两名独立的审阅者完成。使用Cochrane偏差风险工具进行随机对照试验评估偏倚风险。使用ReviewManager5.4软件进行数据分析。采用亚组分析和敏感性分析对异质性较高的结果进行补充。遵循2020年系统审查和荟萃分析指南的首选报告项目。
结果:纳入12项研究。Meta分析发现,与对照组相比,MCE显著影响步态速度(MD=0.11;95CI0.06,0.16,I2=0%),但对平衡能力的影响无统计学意义。亚组分析表明,MCE(≥60分钟)可有效提高步行耐力。这些结果表明,多组分运动可以改善中风患者的步行耐力和步行速度。
结论:多成分运动有助于改善中风幸存者的步态速度。延长多分量运动时间对提高脑卒中患者的步行耐力有较好的效果。
OBJECTIVE: To evaluate whether Multi-component exercise (MCE) is more effective than single exercise in improving walking ability in stroke patients.
METHODS: Systematic review and meta-analysis.
METHODS: 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.
METHODS: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.