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The effectiveness of group exercise for improving activity and participation in adult stroke survivors: a systematic review

Abstract

Background

Following post stroke rehabilitation, group exercise interventions can be used to continue improving cardiovascular fitness, activity levels, balance, gait, movement efficiency, and strengthening. However, little is known of the effectiveness of group exercise for improving activity and participation in stroke survivors.

Objectives

This review aims to assess the effectiveness of group exercise for improving activity and participation in adult stroke survivors.

Data sources

Databases searched were MEDLINE, Web of Science (Core collection), CINAHL, and the Cochrane Library.

Study eligibility criteria

Randomised controlled trials (RCTs) of group exercise using validated outcome measures of activity and participation for post stroke rehabilitation. Two independent reviewers assessed all abstracts, extracted data, conducted a narrative synthesis and assessed the quality of all included articles. The Cochrane Risk of Bias Tool assessed methodological quality and included outcome measure quality was assessed.

Results

14 RCTs were included (n = 624 chronic stroke survivors collectively). Studies ranged between 12 and 243 stroke participants with an average of left:right hemisphere lesions of 32:39 and average age was 66.7 years. Although intervention and control groups improved, no significant difference between group differences were evident.

Conclusion

and implications of key findings: The review found improvements are short-term and less evident at long-term follow up with little improvements in participation after 6 months. However, this review was limited to the standard of intervention reporting. Further research should consider consistency in measuring underpinning mechanisms of group exercise interventions, which may explain the lack of activity changes in long-term follow-up.

Systematic review registration number PROSPERO

CRD42017078917.

Citation

The effectiveness of group exercise for improving activity and participation in adult stroke survivors: a systematic review