Effects of muscle strengthening and cardiovascular fitness activities for poliomyelitis survivors: A systematic review and meta-analysis.

The authors rated the overall evidence as very low certainty, so these results should not be treated as proof that exercise works. The included studies varied widely in design, duration, participants, interventions and outcome measures, and the pooled results showed substantial to considerable heterogeneity. Publication bias was detected for the overall body function and lower limb results, but the authors chose not to apply the trim-and-fill correction because they considered large unpublished negative effects unlikely. Some significant pooled effects did not remain significant when one study was removed in sensitivity analyses. Many programmes combined aerobic fitness, muscle strengthening and functional activities, so the review cannot identify which component caused any benefit. Studies often excluded people with severe weakness or very low manual muscle grades, so the results may not apply to more impaired polio survivors. The search was limited to English-language studies.

Do not read the small improvements as proof that exercise works for all polio survivors. The evidence was very low, results varied widely, publication bias was detected, and mixed programmes combined aerobic, strengthening and functional training, so the contribution of any single component cannot be separated.