Understanding how cardiorespiratory training is implemented to address cardiorespiratory fitness in adults following a stroke: a systematic review

Purpose: To systematically review the evidence investigating the implementation of cardiorespiratory (CR) training in adults following a stroke and to understand how interventions are prescribed to address cardiorespiratory fitness (CRF). Methods: Medline, CINAHL, EMBASE, EMCARE, Scopus, PEDro and ProQuest were searched from inception until January 2024. Inclusion criteria were studies that included adults following a stroke, investigated CR training interventions and used standardised CRF assessments. Commentaries, review publications and non-English studies were excluded. Results: A total of 8565 studies were identified and 121 met the selection criteria. A broad range of participant demographics, stroke characteristics and clinical presentations were identified. Of the included studies, 14% selected only participants within 3-months following stroke and 5% selected only participants requiring assistance to ambulate. Different standardised CRF assessments were used, and CR training intervention parameters varied (frequency, intensity, type, time, volume and progressions). Three studies included qualitative participant perspectives regarding participation in CRF interventions. Conclusions: A variety of CR training interventions and parameters are used to address CRF following stroke, and experiences of participants is not well understood. Future studies should explore CR training interventions for improving CRF, particularly in people requiring assistance to ambulate, or within sub-acute stroke timeframes.