22. European Stroke Conference 896 Meta-analysis and reviews Exercise training interventions that are aerobic or include an aerobic component can improve cardiorespiratory fitness after stroke: a systematic review with meta-analysis. D.L. Marsden1, A. Dunn2, R. Callister3, C.R. Levi4, N.J. Spratt5 University of Newcastle and Hunter Medical Research Institute, New Lambton Heights, AUS-TRALIA1, University of Newcastle and Hunter Medical Research Institute, New Lambton Heights, AUSTRALIA2, University of Newcastle and Hunter Medical Research Institute, New Lambton Heights, AUSTRALIA3, University of Newcastle and Hunter Medical Research Institute, New Lambton Heights, AUSTRALIA4, University of Newcastle and Hunter Medical Research Institute, New Lambton Heights, AUSTRALIA5 Background: Guidelines recommend 30 minutes of moderate intensity physical activity most days of the week. However most stroke survivors are sedentary and have low cardiorespiratory fitness levels. Improving fitness may result in better function and reduced risk of subsequent cardiovascular events. This review with meta-analysis aims to determine the effectiveness of interventions to im-prove cardiorespiratory fitness after stroke and identify their characteristics. Methods: A systematic search and review with meta-analysis was undertaken. Key inclusion criteria were: peer-reviewed articles published in English, adult stroke survivors, an intervention with the potential to improve cardiorespiratory fitness, and peak oxygen consumption (VO2peak) assessed pre and post-intervention via a progressive aerobic exercise test. Results: From 3208 citations identified, 12 randomised controlled trials were included in the me-ta- analysis, reporting results for 310 intervention and 266 control participants. Mean age ranged from 53.2(8.3) to 70.2(11.4) years. Baseline VO2peak values were low (8-23ml/kg/min). Studies typically included chronic, ambulant participants with mild to moderate deficits; used an aerobic (treadmill=4, cycle ergometer=2, water exercise=1) or mixed (an aerobic component in conjunction with usual care, strength, balance and/or endurance activities= 5) intervention. Overall improvement in VO2peak was 2.27 (95%CI:1.58, 2.95) ml/kg/min, with a similar improvement (10-15%) for both aerobic and mixed interventions. No intervention met the recommended levels of physical activity. Conclusions: The results demonstrate even modest dose interventions with an aerobic component can improve cardiorespiratory fitness post-stroke. The key factor appears to be “aerobic” with the type being less important. Further investigation is required to determine the minimum aerobic dose required to improve fitness and whether a larger dose can generate greater improvement. 820 © 2013 S. Karger AG, Basel Scientific Programme 897 Meta-analysis and reviews Systematic review of frequency of cystatin C and APP mutations in sporadic cerebral amyloid angiopathy-related haemorrhage M.O. McCarron1, J.A. Nicoll2 Altnagelvin Neurology Centre, Derry, UNITED KINGDOM1, University of Southampton, Southampton, UNITED KINGDOM2 Background Cerebral amyloid angiopathy (CAA) is a recognized cause of lobar haemorrhage (CAAH). It is not clear whether genetic mutations recognised in familial forms of CAAH contribute to sporadic cases of CAAH. We systematically reviewed the literature for genetic mutations in cystatin C (L68Q) and Amyloid Precursor Protein (including Dutch, Flemish, Arctic, Italian and Iowa variants) in patients with pathological evidence of CAAH. Methods A systematic literature search of genetic causes of pathologically verified sporadic CAAH was car-ried out for cystatin C mutation (L68Q) from 1988 when the L68Q mutation was identified. A search was similarly performed for APP mutations from 1990 (when the Dutch type of Hereditary Cerebral Haemorrhage with Cerebral amyloid angiopathy was identified). References from the searches were examined in addition to the authors’ own references. Results Cystatin C L68Q was examined in 52 patients. One sporadic case of CAAH harboured the cysta-tin C L68Q mutation in an American patient of Croatian origin. APP mutations were not identified among 154 patients with sporadic CAAH. Conclusions Cystatin C mutationL68Q is a rare cause of sporadic CAAH. To date no APP mutations have been identified in sporadic CAAH patients.
Karger_ESC London_2013
To see the actual publication please follow the link above