Objective To examine the effects of strength training on patient-important outcomes of stroke recovery and to quantify the influence of the exercise prescription on treatment effects. Design Systematic review and meta-analysis. Data sources Eight electronic databases (MEDLINE, EMBASE, EMCARE, AMED, PsycINFO, CINAHL, SPORTDiscus, and Web of Science) and two clinical trial registries (ClinicalTrials.gov and WHO International Clinical Trials Registry Platform) were searched from inception to 19 June 2024. Eligibility criteria Randomised controlled trials were eligible if they examined the effects of strength training compared with no exercise or usual care and reported at least one exercise prescription parameter. An advisory group of community members with lived experience of stroke helped inform outcomes most relevant to stroke recovery. Results Forty-two randomised trials (N=2204) were included. Overall risk of bias was high across most outcomes. Strength training improved outcomes rated as ‘critical for decision-making’ by the advisory group, including walking capacity (standardised mean difference (SMD)=0.95 (95% CI 0.34–1.56)), balance (SMD=1.13 (0.51–1.75)), functional ability and mobility (SMD=0.61 (0.09–1.14)), and habitual (mean difference (MD)=0.05 m/s (0.02–0.09)) and fast-paced walking speed (MD=0.09 m/s (0.01–0.17)), with very low to moderate certainty of evidence, mainly due to risk of bias and inconsistency. More frequent strength training, traditional strength training programmes and power-focused intensities (ie, emphasis on movement velocity) were positively associated with walking capacity, health-related quality of life and fast-paced walking speed. Conclusion Strength training alone or combined with usual care improves stroke recovery outcomes that are important for decision-making. More frequent strength training, power-focused intensities and traditional programme designs may best support stroke recovery. PROSPERO registration number CRD42023414077. Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. All individual study data included in this review are available directly from the original manuscripts. Any other data used for this review are available on reasonable request.

中文翻译：

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为中风恢复开具力量训练处方：随机对照试验的系统评价和荟萃分析


目的 探讨力量训练对脑卒中恢复患者重要结局的影响，并量化运动处方对治疗效果的影响。设计 系统评价和荟萃分析。数据来源 检索了八个电子数据库（MEDLINE、EMBASE、EMCARE、AMED、PsycINFO、CINAHL、SPORTDiscus 和 Web of Science）和两个临床试验注册库（ClinicalTrials.gov 和 WHO 国际临床试验注册平台），检索时间从建库到 2024 年 6 月 19 日。纳入标准随机对照试验如果检查了力量训练与不运动或常规护理相比的效果，并报告了至少一个运动处方参数，则这些试验符合条件。一个由具有中风生活经历的社区成员组成的咨询小组帮助告知与中风恢复最相关的结果。结果 共纳入 42 项随机试验 （N=2204）。大多数结局的总体偏倚风险较高。力量训练改善了被咨询小组评为“对决策至关重要”的结果，包括步行能力（标准化均数差 （SMD）=0.95（95% CI 0.34-1.56））、平衡（SMD=1.13 （0.51-1.75））、功能能力和活动能力（SMD=0.61 （0.09-1.14））和习惯性（平均差 （MD）=0.05 m/s （0.02-0.09））和快节奏步行速度（MD=0.09 m/s （0.01-0.17））， 证据质量为极低到中等，主要是由于偏倚风险和不一致性。更频繁的力量训练、传统的力量训练计划和以力量为中心的强度（即强调运动速度）与步行能力、健康相关生活质量和快节奏步行速度呈正相关。 结论 单独力量训练或结合常规护理可改善中风恢复结局，这对决策很重要。更频繁的力量训练、以力量为中心的强度和传统的计划设计可能最能支持中风恢复。PROSPERO 注册号 CRD42023414077。数据可根据合理要求提供。与研究相关的所有数据都包含在文章中或作为补充信息上传。本综述中包括的所有单个研究数据都可以直接从原始手稿中获得。用于此审核的任何其他数据均可在合理要求提供。