PTOTSystematic ReviewJournal of neuroengineering and rehabilitation2025

Effect of exercise-based interventions on stroke rehabilitation: an umbrella review of systematic reviews and meta-analyses.

Minghui Du, Longwei Chen, Yan Li and 6 others

PMID 41250143

WHAT IT FOUND

Exercise improves balance, strength, and walking after stroke, but the best type depends on how long it has been since the event.

Trunk exercises help most in the subacute phase, while aerobic training aids chronic recovery. Most evidence is moderate quality, so tailor prescriptions carefully.

Key findings

01Trunk exercises significantly improved Berg Balance Scale scores in subacute stroke patients compared to conventional therapy, with a mean difference of 13.17 points.

02Aerobic exercise significantly improved 6-minute walk test performance in chronic stroke patients compared to conventional therapy, with a standardized mean difference of 0.366.

03High-intensity aerobic exercise significantly increased peak oxygen consumption and reduced systolic blood pressure in stroke patients compared to conventional therapy.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

Most evidence was of moderate or low quality; only five pieces of evidence were rated high quality. Included studies often did not differentiate between ischemic and hemorrhagic stroke, which may have different rehabilitation needs. Adverse event reporting was inconsistent and sparse, making safety conclusions tentative. Definitions of exercise intensity and dose varied across studies, complicating direct comparisons. Network meta-analyses were excluded, limiting the ability to rank the relative effectiveness of different exercise types. Patient adherence and dropout rates were not systematically evaluated.

Declared interests

None reported in the text.

The easy way to misread this

Do not assume all exercise types are equally effective for all outcomes or stages. The benefits of specific interventions like trunk exercises or high-intensity aerobic training are tied to particular stroke phases and outcome measures, and the overall quality of evidence is mostly moderate, not high.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →