Elucidating the role of physical exercises in alleviating stroke-associated homeostatic dysregulation: a systematic review and meta-analysis.

Background: This study aimed to investigate the role of physical exercises as a non-pharmacological intervention for ameliorating post-stroke dysregulated homeostatic parameters.

Methods: Embase, PubMed, PEDro, ISI Web of Science and CENTRAL were searched until April 2024. Parallel randomised controlled trials (RCTs) analysing the effect of post-stroke physical exercises (PSPE) on homeostatic parameters such as blood glucose, oxygen consumption (VO₂), high-density lipoprotein (HDL), low-density lipoprotein (LDL), systolic (SBP) and diastolic blood pressure (DBP) in individuals with stroke were selected.

Results: Sixteen RCTs (n=698) were included. PSPE reduced fasting glucose levels (MD=-0.22; 95% CI -0.22 to -0.02; p=0.00) and increased the VO₂ (MD=2.51; 95% CI 1.65 to 3.37; p=0.00) and blood HDL levels (MD=0.07; 95% CI 0.00 to 0.13; p=0.00). However, we did not observe beneficial effects on LDL, SBP and DBP parameters. Further analyses demonstrated that both low and moderate exercises are more suitable for improving blood glucose and VO₂ in this population.

Discussion: PSPE have the potential to improve dysregulated post-stroke parameters by reducing blood glucose levels and increasing VO₂ and HDL levels. However, the small size and limited number of included studies limited the precision of our results. Further research is needed to comprehensively analyse the effects of PSPE, particularly on LDL levels and blood pressure.

Prospero registration number: CRD42023395715.