Comparing the effectiveness of different exercise interventions on quality of life in stroke patients: a randomized controlled network meta-analysis

Background: This study evaluates the comprehensive impact of different exercise interventions on the quality of life in stroke patients through network meta-analysis, aiming to provide scientific evidence for developing more effective rehabilitation programs and improving patients' physical, psychological, and social functions.

Methods: This systematic review, registered in PROSPERO (CRD42024541517) and following PRISMA guidelines, searched multiple databases (PubMed, Web of Science, EMbase, Cochrane, Ebsco) until November 1, 2024. Studies were selected based on the PICOS criteria, including RCTs on stroke and exercise. Methodological quality was assessed using RoB 2. Data analysis involved effect size calculations and network meta-analysis in Stata 17.0, with publication bias detected via funnel plots.

Results: This meta-analysis included 41 studies (2,578 stroke patients) from 15 countries, published between 2002 and 2024. Participants aged 50-70 underwent interventions lasting 3 weeks to 6 months. DTOT (Dual-task oriented training)was most effective for Quality of Life, Mental Health, and Upper Limb Function; AQE (Aquatic Exercise) for Physical Health and Social Participation; ST(Strength Training) for Pain and Vitality; CIT(Constraint-Induced Therapy) for Mobility and Recovery; BCT for Memory and Thinking; ALCE(Aquatic and Land Combined Exercise) for Emotion and ADL; and ULT(Upper Limb Training) for Communication. No significant publication bias was found.

Conclusion: This study indicates that different training methods have a significant impact on various dimensions of quality of life in stroke patients. Future research should focus on personalized rehabilitation programs, considering individual differences among patients, and explore multimodal integrated interventions to optimize outcomes. Long-term follow-up and outcome assessments should be strengthened to ensure the sustainability of interventions. Additionally, integrating mental health and social participation is essential to enhance overall quality of life. Emerging technologies such as VR, AI, and wearable devices can help optimize rehabilitation training. Interdisciplinary collaboration combining neuroscience, rehabilitation science, and psychology can provide more comprehensive rehabilitation solutions.