Effect of aerobic training on vascular and metabolic risk factors for recurrent stroke: a meta-analysis

Rafaël Brouwer; Roderick Wondergem; Carlijn Otten; Martijn F Pisters

doi:10.1080/09638288.2019.1692251

Effect of aerobic training on vascular and metabolic risk factors for recurrent stroke: a meta-analysis

Disabil Rehabil. 2021 Jul;43(15):2084-2091. doi: 10.1080/09638288.2019.1692251. Epub 2019 Dec 3.

Authors

Rafaël Brouwer^{1

2}, Roderick Wondergem^{2

3

4

5}, Carlijn Otten², Martijn F Pisters^{2

3

4

5}

Affiliations

¹ Royal Dutch Society for Physical Therapy (KNGF), Amersfoort, the Netherlands.
² Department of Physical Therapy Sciences, Program in Clinical Health Sciences, University Medical Center, Utrecht, the Netherlands.
³ Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, the Netherlands.
⁴ Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands.
⁵ Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, the Netherlands.

PMID: 31794269
DOI: 10.1080/09638288.2019.1692251

Abstract

Aim: This meta-analysis aimed to determine the effect of aerobic training, compared to non-aerobic interventions, on vascular and metabolic risk factors for recurrent stroke.

Method: This study was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines (PRISMA). Searches were performed in PubMed, Embase, Cochrane library and Cinahl up to May 8^th 2019. Randomized clinical trials evaluating the effect of solely aerobic training on vascular and metabolic risk factors for recurrent stroke were included in a meta-analysis if relevant outcomes were reported in at least two articles.

Results: Our search resulted in a total of 7381 hits. Eleven outcomes out of nine articles were included in the meta-analysis. A significant positive effect of aerobic training was found on systolic blood pressure (-3.59 mmHg, 95% CI -6.14 to -1.05) and fasting glucose (-0.12 mmol/l, 95% CI -0.23 to -0.02). The effect on systolic blood pressure further improved when only high-quality studies were included (-4.95 mmHg, 95% CI -8.24 to -1.66).

Conclusion: Aerobic training results in a significant positive effect on systolic blood pressure and fasting glucose after stroke when compared to non-aerobic usual care or non-aerobic exercise.Implications for rehabilitationAerobic training has a positive effect on two of the most important vascular risk factors for recurrent stroke (i.e., systolic blood pressure and fasting glucose).The effect of solely aerobic training seems to be comparable to the effect of combined strength exercise and aerobic training for systolic blood pressure and fasting glucose.Since aerobic training has a significant effect on risk factors for recurrent stroke, implementation of aerobic training in daily life is important to reduce long term stroke risk.Previous research has showed that other metabolic risk factors can be altered by other interventions (e.g., strength exercise or lifestyle coaching), therefore, post-stroke prevention programs should be tailored in order to target specific risk-factors for individual patients.

Keywords: Stroke; blood pressure; exercise; rehabilitation; risk factors; secondary prevention.

Publication types

Meta-Analysis

MeSH terms

Blood Pressure
Exercise*
Humans
Life Style
Risk Factors
Stroke*