The effect of exercise on walking economy in patients with chronic neurological conditions: A systematic review and meta-analysis

Bowen Liu; Jingxuan Yu; Qiwei Fan; Fengwei Hao; Jinlong Wu; Wen Xiao; Fengyu Yu; Zhanbing Ren

doi:10.3389/fneur.2022.1074521

The effect of exercise on walking economy in patients with chronic neurological conditions: A systematic review and meta-analysis

Front Neurol. 2023 Jan 11:13:1074521. doi: 10.3389/fneur.2022.1074521. eCollection 2022.

Authors

Bowen Liu¹, Jingxuan Yu¹, Qiwei Fan², Fengwei Hao³, Jinlong Wu⁴, Wen Xiao¹, Fengyu Yu¹, Zhanbing Ren¹

Affiliations

¹ College of Physical Education, Shenzhen University, Shenzhen, China.
² Department of Sports Medicine and Rehabilitation, Peking University Shenzhen Hospital, Shenzhen, China.
³ School of Physical Education and Sports Exercise, South China Normal University, Guangzhou, China.
⁴ College of Physical Education, Southwest University, Chongqing, China.

Abstract

Introduction: To investigate the effect of exercise on the walking economy (WE) of patients with chronic neurological conditions (CNCs) and to determine the type of physical activity that best improves the WE of patients with CNCs.

Methods: Four electronic databases were searched until December 2022 (Web of Science, PubMed, Cochrane, and CINAHL). Studies were screened using the following inclusion criteria: 1. randomized controlled or non-randomized controlled trials; 2. exercise interventions >4 weeks in duration; 3. patients aged ≥18 years with a diagnosis of CNCs. 4. walking economy of patients measured before and after the intervention. The PEDro scale was used to assess the methodological quality of the included studies.

Results and discussion: Twenty-two studies met the inclusion criteria. Meta-analysis results showed that exercise significantly improved WE (g = -0.352, 95% CI, -0.625 to -0.078, P = 0.012). Subgroup analysis revealed that patients who received exercise showed better WE compared with those who underwent no control intervention (g = -0.474, 95% CI, -0.636 to -0.311, P < 0.001). However, exercise therapy did not show a significant improvement of WE compared with control groups (g = -0.192, 95% CI, -0.451 to 0.067, P = 0.146). In addition, we found that endurance combined with resistance, high-intensity intermittent, and other training modalities resulted in better WE compared with the pre-intervention. Of these, interval training has the greatest effect on improving WE. In conclusion, exercise can improve WE in patients with CNCs. More randomized controlled trials are necessary for the future.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022361455, identifier: CRD42022361455.

Keywords: chronic neurological conditions; energy cost; exercise; rehabilitation; walking.

Publication types

Systematic Review

Grants and funding

The article was supported by the National Natural Science Foundation of China (NSFC) [Grant No.: 11002036]; the Research Foundation for Young Teachers of Shenzhen University [Grant No.: QNJS0274]; the High-level Scientific Research Foundation for the Introduction of Talent of Shenzhen University [Grant No.: RC00228]; the Natural Science Featured Innovation Projects in Ordinary Universities in Guangdong Province [Grant No.: 2021KTSCX297]; and the Scientific Research Platform and Project of Colleges and Universities of the Education Department of Guangdong Province (2022ZDZX2087).