Do trials of resistance training to improve mobility after stroke adhere to the American College of Sports Medicine guidelines? A systematic review

Publication date: Available online 26 July 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Genevieve Hendrey, Anne E. Holland, Benjamin F. Mentiplay, Ross Clark, Gavin Williams
ObjectiveTo determine whether resistance training to improve mobility outcomes after stroke adhere to the ACSM guidelines, and whether adherence was associated with better outcomes.Data sourcesOnline databases searched from 1975 to 30 October 2016.Study SelectionRandomized controlled trials examining the effectiveness of lower limb strength training on mobility outcomes in adult stroke participants.Data Extraction and AnalysisTwo independent reviewers completed data extraction. Quality of trials was determined using the Cochrane Risk of Bias Tool. Trials were scored based on their protocol's adherence to eight ACSM recommendations. To determine if a relationship existed between total adherence score and effect size, Spearman's rho (rs) was calculated and between individual recommendations and effect size, Mann Whitney U or Kruskal Wallis tests were used.ResultsThirty-nine trials met the inclusion criteria and 34 were scored on their adherence to the guidelines. Adherence was high for frequency of training (100% of studies) but few trials adhered to the guidelines for intensity (32%), specificity (24%), and training pattern (3%). Based on the small number of studies that could be included in pooled analysis (n = 12), there was no relationship between overall adherence and effect size (rs = -0.39, p = 0.21).ConclusionsAdherence to the ACSM guidelines for resistance training following stroke varied widely. Future trials should ensure strength training protocols adhere more closely to the guidelines, to ensure their effectiveness in stroke can be accurately determined.



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