Effectiveness of walking versus other physical exercises for chronic stroke survivors: A systematic review and Meta-analysis of Recent Randomized Controlled Trials

Introduction: Stroke is a leading cause of long-term disability. Inactivity associated with disability can expose victims to recurrent cardiovascular risks. Recovery of walking to regain independence in daily life is one of the main goals of stroke patients. Walking is an aerobic physical activity, which improves functional independence in stroke survivors, and physical activity is worldwide recommended as preventive and curative care after stroke. Objective: To determine the effectiveness of walking trainings versus other physical activities for chronic stroke rehabilitation. Methods: We systematically searched recent Randomized Controlled Trials (2008-2018) for adult chronic stroke survivors, which were published in English or in French. Four databases were consulted (PubMed, Scopus, Cochrane Library, and Science direct) and we recorded 2773 trials. After selection, 49 RCTs were included and were analyzed. Results: There was significant effect of walking trainings on balance (SMD = 0.44, p<0.00001,), motor impairments (SMD = 0.46, p=0.004, table 1), walking endurance and speed (respectively SMD = 0.47, p<0.00001 and 0, 27 p=0,001), functional autonomy (SMD = 0.33, p=0, 0008) and quality of life (SMD = 0.34, p=0,005). Pooled effect of walking trainings on participation was not significant (SMD=0, 24, p=0, 25). Conclusion: Walking training conducted 20–60 min and 3–5 days per week is beneficial for improving impairments, activity limitation and quality of life in people who had stroke. The effects of walking trainings on participation require further studies. Specifically, treadmill and overground trainings were the more effective in improving stroke survivors functioning. Walking trainings, especially overground walking could be implemented in low-income countries.