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Effect of lower limb resistance training on ICF components in chronic stroke: A systematic review and meta-analysis of RCTs - 19/11/23

Doi : 10.1016/j.rehab.2023.101766 
Tales Andrade Pereira a, Marcos Paulo Braz de Oliveira b, , Paula Regina Mendes da Silva Serrão c, Carolina Tsen b, Nataly Barbieri Coutinho a, Rubens Vinícius Letieri d, Adriana Teresa Silva Santos a, Luciana Maria dos Reis a
a Department of Physical Therapy, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil 
b Healthy Aging Research Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil 
c Rheumatology and Hand Rehabilitation Research Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil 
d Department of Physical Education, Federal University of North Tocantins, Araguaia, Tocantins, Brazil 

Corresponding author at: Healthy Aging Research Laboratory, Department of Physical Therapy, Federal University of São Carlos, Washington Luis Highway, Km 235, São Carlos, São Paulo, Brazil.Healthy Aging Research Laboratory, Department of Physical TherapyFederal University of São CarlosWashington Luis Highway, Km 235São CarlosSão PauloBrazil

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Abstract

Background

Resistance training (RT) effectively promotes functional independence after stroke.

Objectives

To investigate the effect of lower limb RT on body structure and function (muscle strength, postural balance), activity (mobility, gait) and participation (quality of life, impact of stroke on self-perceived health) outcomes in individuals with chronic stroke.

Methods

Six databases were searched from inception until September 2022 for randomized controlled trials comparing lower limb RT to a control intervention. The random-effects model was used in the meta-analyses. Effect sizes were reported as standardized mean differences (SMD). Quality of evidence was assessed using the GRADE approach.

Results

Fourteen studies were included. Significant improvements were found in body structure and function after lower limb RT: knee extensors (paretic side – SMD: 1.27; very low evidence), knee flexors (paretic side – SMD: 0.51; very low evidence; non-paretic side – SMD: 0.52; low evidence), leg press (paretic side – SMD: 0.83; very low evidence) and global lower limb muscle strength (SMD: -1.47; low evidence). No improvement was found for knee extensors (p = 0.05) or leg press (p = 0.58) on the non-paretic side. No improvements were found in the activity domain after lower limb RT: mobility (p = 0.16) and gait (walking speed-usual: p = 0.17; walking speed-fast: p = 0.74). No improvements were found in the participation domain after lower limb RT: quality of life (p > 0.05), except the bodily pain dimension (SMD: 1.02; low evidence) or the impact of stroke on self-perceived health (p = 0.38).

Conclusion

Lower limb RT led to significant improvements in the body structure and function domain (knee extensors and flexors, leg press, global lower limb muscle strength) in individuals with chronic stroke. No improvements were found in the activity (mobility, gait [walking speed]) or participation (quality of life, impact of stroke on self-perceived health) domains.

PROSPERO registration number

CRD42021272645.

Le texte complet de cet article est disponible en PDF.

Keywords : Stroke, Muscle strength, Resistance training, Rehabilitation, International Classification of Functioning Disability and Health, Systematic review and meta-analysis

Abbreviations : CI, GRADE, ICF, PICO, PEDro, PRISMA, PROSPERO, RCTs, RT, SMD


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Vol 66 - N° 7

Article 101766- octobre 2023 Retour au numéro
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