Aim was to determine the effects of additional exercise therapy on gait, gait-related activities, and (basic and extended) activities of daily living (ADL) within the first 6 months after stroke. A systematic literature search of electronic databases from 1 January 1990 to 18 October 2010 was performed. Randomized controlled trials were included if the experimental group spent more time on lower-limb exercises than the control group. Outcomes were gait, gait-related activities, and (basic and extended) ADL. Results from individual studies were pooled by calculating the summary, effect sizes (SESs). Sensitivity analysis was used to determine whether the magnitude of the treatment difference, when therapy started, type of control intervention, and methodological quality influenced the homogeneity and magnitude of the effect sizes detected. In total, 4,966 studies were identified, of which 14 (n = 725) were included. The studies differed in terms of when therapy was started and in the type of experimental and control interventions. Pooling resulted in small-to moderate significant SESs in favour of additional exercise therapy for walking ability, comfortable and maximum walking speed, and extended ADL. No significant effects were found for basic ADL. Similar results were obtained after sensitivity analysis. Dose-response trials in stroke rehabilitation are heterogeneous. The present meta-analysis suggests that more time spent on training gait and gait-related activities in the first 6 months after stroke results in significant small-to-moderate effects in terms of walking ability, walking speed, and extended ADL. High-quality dose response exercise training trials are needed with identical treatment goals but incremental levels of intensity.

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