Work

Effects of cardiorespiratory physiotherapy on cardiovascular fitness in patients with stroke: A systematic review and network meta-analysis

Year: 2025

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: BACKGROUND: This study aimed to investigate the effectiveness and ranking of different cardiorespiratory-physiotherapy interventions on cardiovascular fitness in patients with stroke. METHODS: In total, 21 randomized controlled trials published between 2000 and 2024 were retrieved from PubMed, EMBASE, Cochrane Library, Web of Science, and CINAHL and analyzed. Outcome measures were resting heart rate (RHR), rating of perceived exertion (RPE), and peak oxygen uptake (VO2peak). A network meta-analysis was conducted using the R netmeta package (version 4.3.2), with rankings based on probability scores (p-scores) representing the likelihood of each intervention being the most effective. RESULTS: RHR rankings were as follows: combined inspiratory and expiratory training (CIET) (p-score: 94.02%), conventional training (CT) (68.16%), robot-assisted training (RAT) (61.27%), aquatic training (AT) (48.90%), ground-based aerobic training (GBAT) (31.61%), combined aerobic and resistance training (CART) (28.01%), and resistance training (RT) (18.03%). However, CIET did not show statistically significant differences in effect compared to other interventions. RPE rankings were as follows: CIET (89.12%), GBAT (72.23%), CT (66.19%), AT (66.01%), CART (30.20%), RAT (19.70%), and inspiratory training (IT) (6.55%). VO2peak rankings were as follows: RT (88.26%), GBAT (73.22%), AT (64.73%), RAT (45.10%), CART (43.34%), sham training (42.88%), IT (39.61%), CIET (28.29%), and CT (24.56%). The evidence quality ranked from very low to moderate. CONCLUSION: CIET ranked highest in reducing RHR and RPE; RT ranked highest in improving VO2peak. Although CIET did not show significant superiority in RHR reduction, its consistent high ranking in RHR and RPE outcomes indicates its potential clinical utility. These findings suggest incorporating targeted respiratory and strength training into stroke-rehabilitation programs to optimize cardiovascular-fitness outcomes.

Source: Medicine

DOI: 10.1097/md.0000000000045286

Authors: So Hyun Kim, Sung Hyoun Cho

Institutions: Cheongju University, Nambu University

Language: English

Topic: Stroke Rehabilitation and Recovery

Subfield: Rehabilitation

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,950