The influence of seated exercises on balance, mobility, and cardiometabolic health outcomes in individuals living with a stroke: A systematic review and meta-analysis.
Paul Mackie, Janice J Eng
PMID 36628495WHAT IT FOUND
Seated exercise improved balance and mobility after stroke, with Berg Balance Scale scores rising 9.84 points.
It did not lower blood pressure in the one trial that measured it. The trials were small and most raised concerns about bias.
Key findings
01Seated exercise improved balance compared with control. Pooling five trials and 255 people gave a significant result, with Berg Balance Scale scores 9.84 points higher, how far people could reach while sitting 0.12 further, and trunk impairment scores 4.32 points higher.
02Mobility also improved across five trials (258 people), but walking speed on its own was borderline (0.32, confidence interval 0.00 to 0.64) and became non-significant when one trial that reported medians was left out (0.33, confidence interval -0.23 to 0.89).
03The only trial that measured blood pressure found no significant change after 8 weeks of moderate-intensity seated resistance exercise compared with physiotherapy, although systolic and diastolic readings were 10.4 and 8.2 mmHg lower in the exercise group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Most of the pooled trials (78%) raised some concerns about bias and 11% were at high risk, and in 89% the reported analysis had not been pre-defined, so results may have been chosen after the fact. Samples were small (12 to 160 people) and only five or six trials could be pooled per outcome; the authors say this may underestimate the effects. Almost everyone studied was within six months of their stroke and in inpatient or rehabilitation care, so this says little about people living with long-standing stroke at home. Walking speed stopped being significant once one trial was removed from the analysis. Only one trial measured blood pressure, only one reported how hard the exercise was, and only two reported how many sessions people actually completed. Control groups varied from routine physiotherapy to attention control, so comparison conditions were not the same across trials. Only English-language trials were included, and exercise delivered through technology such as video games was deliberately excluded.
Declared interests
The authors declared no competing interests. The work was funded by the Michael Smith Foundation for Health Research (a fellowship to one author), a Canadian Institutes of Health Research Foundation Grant, and the Canada Research Chairs Program. No company that sells or delivers the intervention funded, designed or wrote up the review.
The easy way to misread this
Do not read this as evidence that seated exercise lowers blood pressure. Only one trial measured blood pressure, it found no significant change compared with physiotherapy, and the lower readings in the exercise group come from that same non-significant comparison.
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 →