Efficacy of combined nutrition and exercise interventions on muscle health and performance in patients after a stroke: protocol for a systematic review and meta-analysis
Abstract
Introduction: Stroke survivors experience profound skeletal muscle deterioration, typically losing 15%-20% of skeletal muscle mass in the affected limb within 4-6 months post-stroke. This deterioration accelerates functional decline, falls and secondary sarcopenia. While combined nutrition and exercise interventions have shown synergistic effects in other muscle-wasting conditions, the evidence for stroke remains fragmented. This systematic review and meta-analysis aims to evaluate the efficacy of combined nutrition and exercise interventions on muscle health and performance in patients after stroke.
Methods and analysis: We will systematically search PubMed, Scopus, Web of Science Core Collection and CNKI from inception without language or date restrictions. Randomised controlled trials evaluating combined structured exercise and nutritional interventions in adults (aged ≥18 years) with stroke will be included. Primary outcomes are muscle strength and muscle mass; secondary outcomes include functional performance, balance, daily living habits, neurological function and muscle composition. Two independent reviewers will conduct screening, data extraction and outcome-level risk-of-bias assessment using the Cochrane Risk of Bias tool for randomised trials. Hierarchical decision rules and robust variance estimation will be applied to address dependent effect sizes arising from multiple time points or concurrent outcome measures. Meta-analyses will be performed using…
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