Many people who have had a stroke have limited activities of daily living and reducing disability is one of the main goals of rehabilitation. Water-based exercises are used in rehabilitation and might help to reduce disability after stroke. This review of four trials, which included 94 participants, found there is not enough evidence to decide if water-based exercises may reduce disability after stroke. There is a lack of hard evidence for water-based exercises after stroke. More research is therefore needed.
阅读完整摘要
Water-based exercises are used in rehabilitation and might help to reduce disability after stroke.
研究目的
To investigate the effect of water-based exercises for reducing disability after stroke.
检索策略
We searched the Cochrane Stroke Group Trials Register (last searched August 2010), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 4), MEDLINE (1966 to April 2010), EMBASE (1980 to April 2010), CINAHL (1982 to April 2010), AMED (1985 to April 2010), SPORTDiscus (1949 to April 2010), the Physiotherapy Evidence Database (PEDro, April 2010) and OT Seeker (1969 to April 2010). In an effort to identify further published, unpublished and ongoing trials we handsearched relevant journals and conference proceedings, searched trials and research registers, checked reference lists and contacted authors.
纳入排除标准
We included studies using random assignment.
资料收集与分析
Two review authors independently selected trials for inclusion, assessed trial quality and extracted the data. The primary outcome was activities of daily living.
主要结果
We included four trials involving 94 participants in this review. There was a significant improvement in activity of daily living (mean difference (MD) 13.20 points on the 'Capacidad funcional' (functional capacity) subscale of the Brazilian-Portuguese version of the SF-36; 95% confidence interval (CI) 8.36 to 18.04; P < 0.00001) and on muscle strength (MD 1.01 Nm/kg; 95% CI 0.19 to 1.83; P = 0.02) but these results should be interpreted with caution because population numbers were small and the results are based on single studies. There was no significant improvement in ability to walk (MD 0.14 m/s; 95% CI -0.32 to 0.606; P = 0.55), postural balance (MD 3.05 points; 95% CI -3.41 to 9.52; P = 0.35) or fitness (MD 3.6 (VO2max; 95% CI -0.53 to 7.73; P = 0.09) after water-based exercises treatment compared to control. Adverse effects were not reported.
作者结论
The evidence from randomised controlled trials so far does not confirm or refute that water-based exercises after stroke might help to reduce disability after stroke. There is a lack of hard evidence for water-based exercises after stroke. Better and larger studies are therefore required.
