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Physical fitness training for stroke patients.
CONCLUSIONS: Few deaths overall suggest exercise is a safe intervention but means we cannot determine whether exercise reduces mortality or the chance of death or dependency. Cardiorespiratory training and, to a lesser extent mixed training, reduce disability during or after usual stroke care; this could be mediated by improved mobility and balance. There is sufficient evidence to incorporate cardiorespiratory and mixed training, involving walking, within post-stroke rehabilitation programmes to improve fitness, balance and the speed and capacity of walking. The magnitude of VO2 peak increase after cardiorespiratory traini...
Source: Cochrane Database of Systematic Reviews - March 19, 2020 Category: General Medicine Authors: Saunders DH, Sanderson M, Hayes S, Johnson L, Kramer S, Carter DD, Jarvis H, Brazzelli M, Mead GE Tags: Cochrane Database Syst Rev Source Type: research

Telerehabilitation services for stroke.
CONCLUSIONS: While there is now an increasing number of RCTs testing the efficacy of telerehabilitation, it is hard to draw conclusions about the effects as interventions and comparators varied greatly across studies. In addition, there were few adequately powered studies and several studies included in this review were at risk of bias. At this point, there is only low or moderate-level evidence testing whether telerehabilitation is a more effective or similarly effective way to provide rehabilitation. Short-term post-hospital discharge telerehabilitation programmes have not been shown to reduce depressive symptoms, improv...
Source: Cochrane Database of Systematic Reviews - January 30, 2020 Category: General Medicine Authors: Laver KE, Adey-Wakeling Z, Crotty M, Lannin NA, George S, Sherrington C Tags: Cochrane Database Syst Rev Source Type: research

Community pharmacy interventions for health promotion: effects on professional practice and health outcomes.
CONCLUSIONS: Health-promotion interventions in the community pharmacy context probably improve pharmacy workers' behaviour and probably have a slight beneficial effect on health-related behaviour, intermediate clinical outcomes, and quality of life for pharmacy users. Such interventions are likely to be cost-effective and the effects are seen across a range of clinical conditions and health-related behaviours. Nevertheless the magnitude of the effects varies between conditions, and more effective interventions might be developed if greater consideration were given to the theoretical basis of the intervention and mechanisms...
Source: Cochrane Database of Systematic Reviews - December 5, 2019 Category: General Medicine Authors: Steed L, Sohanpal R, Todd A, Madurasinghe VW, Rivas C, Edwards EA, Summerbell CD, Taylor SJ, Walton RT Tags: Cochrane Database Syst Rev Source Type: research

Interventions for visual field defects in people with stroke.
CONCLUSIONS: There is a lack of evidence relating to the effect of interventions on our primary outcome of functional ability in activities of daily living. There is limited low-quality evidence that compensatory scanning training may be more beneficial than placebo or control at improving quality of life, but not other outcomes. There is insufficient evidence to reach any generalised conclusions about the effect of restitutive interventions or substitutive interventions (prisms) as compared to placebo, control, or no treatment. There is low-quality evidence that prisms may cause minor adverse events. PMID: 31120142 [...
Source: Cochrane Database of Systematic Reviews - May 22, 2019 Category: General Medicine Authors: Pollock A, Hazelton C, Rowe FJ, Jonuscheit S, Kernohan A, Angilley J, Henderson CA, Langhorne P, Campbell P Tags: Cochrane Database Syst Rev Source Type: research

Exercise for preventing falls in older people living in the community.
CONCLUSIONS: Exercise programmes reduce the rate of falls and the number of people experiencing falls in older people living in the community (high-certainty evidence). The effects of such exercise programmes are uncertain for other non-falls outcomes. Where reported, adverse events were predominantly non-serious.Exercise programmes that reduce falls primarily involve balance and functional exercises, while programmes that probably reduce falls include multiple exercise categories (typically balance and functional exercises plus resistance exercises). Tai Chi may also prevent falls but we are uncertain of the effect of res...
Source: Cochrane Database of Systematic Reviews - January 31, 2019 Category: General Medicine Authors: Sherrington C, Fairhall NJ, Wallbank GK, Tiedemann A, Michaleff ZA, Howard K, Clemson L, Hopewell S, Lamb SE Tags: Cochrane Database Syst Rev Source Type: research

Electromechanical and robot-assisted arm training for improving activities of daily living, arm function, and arm muscle strength after stroke.
CONCLUSIONS: People who receive electromechanical and robot-assisted arm training after stroke might improve their activities of daily living, arm function, and arm muscle strength. However, the results must be interpreted with caution although the quality of the evidence was high, because there were variations between the trials in: the intensity, duration, and amount of training; type of treatment; participant characteristics; and measurements used. PMID: 30175845 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - September 3, 2018 Category: General Medicine Authors: Mehrholz J, Pohl M, Platz T, Kugler J, Elsner B Tags: Cochrane Database Syst Rev Source Type: research

Treadmill training and body weight support for walking after stroke.
CONCLUSIONS: Overall, people after stroke who receive treadmill training, with or without body weight support, are not more likely to improve their ability to walk independently compared with people after stroke not receiving treadmill training, but walking speed and walking endurance may improve slightly in the short term. Specifically, people with stroke who are able to walk (but not people who are dependent in walking at start of treatment) appear to benefit most from this type of intervention with regard to walking speed and walking endurance. This review did not find, however, that improvements in walking speed and en...
Source: Cochrane Database of Systematic Reviews - August 17, 2017 Category: General Medicine Authors: Mehrholz J, Thomas S, Elsner B Tags: Cochrane Database Syst Rev Source Type: research

Electromechanical-assisted training for walking after stroke.
CONCLUSIONS: People who receive electromechanical-assisted gait training in combination with physiotherapy after stroke are more likely to achieve independent walking than people who receive gait training without these devices. We concluded that seven patients need to be treated to prevent one dependency in walking. Specifically, people in the first three months after stroke and those who are not able to walk seem to benefit most from this type of intervention. The role of the type of device is still not clear. Further research should consist of large definitive pragmatic phase III trials undertaken to address specific que...
Source: Cochrane Database of Systematic Reviews - May 10, 2017 Category: General Medicine Authors: Mehrholz J, Thomas S, Werner C, Kugler J, Pohl M, Elsner B Tags: Cochrane Database Syst Rev Source Type: research

Caregiver-mediated exercises for improving outcomes after stroke.
CONCLUSIONS: There is very low- to moderate-quality evidence that CME may be a valuable intervention to augment the pallet of therapeutic options for stroke rehabilitation. Included studies were small, heterogeneous, and some trials had an unclear or high risk of bias. Future high-quality research should determine whether CME interventions are (cost-)effective. PMID: 28002636 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - December 20, 2016 Category: Journals (General) Authors: Vloothuis JD, Mulder M, Veerbeek JM, Konijnenbelt M, Visser-Meily JM, Ket JC, Kwakkel G, van Wegen EE Tags: Cochrane Database Syst Rev Source Type: research

Repetitive task training for improving functional ability after stroke.
CONCLUSIONS: There is low- to moderate-quality evidence that RTT improves upper and lower limb function; improvements were sustained up to six months post treatment. Further research should focus on the type and amount of training, including ways of measuring the number of repetitions actually performed by participants. The definition of RTT will need revisiting prior to further updates of this review in order to ensure it remains clinically meaningful and distinguishable from other interventions. PMID: 27841442 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - November 13, 2016 Category: Journals (General) Authors: French B, Thomas LH, Coupe J, McMahon NE, Connell L, Harrison J, Sutton CJ, Tishkovskaya S, Watkins CL Tags: Cochrane Database Syst Rev Source Type: research

Self management programmes for quality of life in people with stroke.
CONCLUSIONS: The current evidence indicates that self management programmes may benefit people with stroke who are living in the community. The benefits of such programmes lie in improved quality of life and self efficacy. These are all well-recognised goals for people after stroke. There is evidence for many modes of delivery and examples of tailoring content to the target group. Leaders were usually professionals but peers (stroke survivors and carers) were also reported - the commonality is being trained and expert in stroke and its consequences. It would be beneficial for further research to be focused on identifying k...
Source: Cochrane Database of Systematic Reviews - August 21, 2016 Category: Journals (General) Authors: Fryer CE, Luker JA, McDonnell MN, Hillier SL Tags: Cochrane Database Syst Rev Source Type: research

Physical fitness training for stroke patients.
CONCLUSIONS: Cardiorespiratory training and, to a lesser extent, mixed training reduce disability during or after usual stroke care; this could be mediated by improved mobility and balance. There is sufficient evidence to incorporate cardiorespiratory and mixed training, involving walking, within post-stroke rehabilitation programmes to improve the speed and tolerance of walking; some improvement in balance could also occur. There is insufficient evidence to support the use of resistance training. The effects of training on death and dependence after stroke are still unclear but these outcomes are rarely observed in physic...
Source: Cochrane Database of Systematic Reviews - March 23, 2016 Category: Journals (General) Authors: Saunders DH, Sanderson M, Hayes S, Kilrane M, Greig CA, Brazzelli M, Mead GE Tags: Cochrane Database Syst Rev Source Type: research

Electromechanical and robot-assisted arm training for improving activities of daily living, arm function, and arm muscle strength after stroke.
CONCLUSIONS: People who receive electromechanical and robot-assisted arm and hand training after stroke might improve their activities of daily living, arm and hand function, and arm and hand muscle strength. However, the results must be interpreted with caution because the quality of the evidence was low to very low, and there were variations between the trials in the intensity, duration, and amount of training; type of treatment; and participant characteristics. PMID: 26559225 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - November 7, 2015 Category: Journals (General) Authors: Mehrholz J, Pohl M, Platz T, Kugler J, Elsner B Tags: Cochrane Database Syst Rev Source Type: research

Exercise for reducing fear of falling in older people living in the community.
CONCLUSIONS: Exercise interventions in community-dwelling older people probably reduce fear of falling to a limited extent immediately after the intervention, without increasing the risk or frequency of falls. There is insufficient evidence to determine whether exercise interventions reduce fear of falling beyond the end of the intervention or their effect on other outcomes. Although further evidence from well-designed randomised trials is required, priority should be given to establishing a core set of outcomes that includes fear of falling for all trials examining the effects of exercise interventions in older people liv...
Source: Cochrane Database of Systematic Reviews - December 2, 2014 Category: Journals (General) Authors: Kendrick D, Kumar A, Carpenter H, Zijlstra GA, Skelton DA, Cook JR, Stevens Z, Belcher CM, Haworth D, Gawler SJ, Gage H, Masud T, Bowling A, Pearl M, Morris RW, Iliffe S, Delbaere K Tags: Cochrane Database Syst Rev Source Type: research

Interventions for improving upper limb function after stroke.
CONCLUSIONS: Large numbers of overlapping reviews related to interventions to improve upper limb function following stroke have been identified, and this overview serves to signpost clinicians and policy makers toward relevant systematic reviews to support clinical decisions, providing one accessible, comprehensive document, which should support clinicians and policy makers in clinical decision making for stroke rehabilitation.Currently, no high-quality evidence can be found for any interventions that are currently used as part of routine practice, and evidence is insufficient to enable comparison of the relative effective...
Source: Cochrane Database of Systematic Reviews - November 12, 2014 Category: Journals (General) Authors: Pollock A, Farmer SE, Brady MC, Langhorne P, Mead GE, Mehrholz J, van Wijck F Tags: Cochrane Database Syst Rev Source Type: research

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