OBJECTIVE: To determine if improvements in cardiorespiratory fitness are maintained in the short-, medium- and long-term after a cardiorespiratory fitness intervention in people with stroke. DATA SOURCES: Medline, Cumulative Index to Nursing and Allied Health Literature, Embase, (CENTRAL) Cochrane, Web of Science, Sports Discus, and Physiotherapy Evidence Database were searched from inception. STUDY SELECTION: Randomized controlled trials and cohort studies including (1) people with stroke; (2) cardiorespiratory fitness interventions; (3) a direct measure of cardiorespiratory fitness; and (4) short- (0 to < 3 months), medium- (3 to 6 months), or long-term (> 6 months) follow-up data. DATA EXTRACTION: Two reviewers independently screened full texts and extracted data, including study methods, participant demographic information, stroke type and severity, outcome measures, intervention information, follow-up time points, and results, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A lower limit of -1.0 mL/kg/min was used to determine maintenance (ie, no change) of cardiorespiratory fitness. DATA SYNTHESIS: Fourteen studies (N = 324 participants) were included. Participants completed cardiorespiratory fitness training 2 to 5 days per week over 4 to 13 weeks at moderate to high intensity (40% to 70% heart rate reserve [HRR]; n = 4 studies), high intensity (60% to < 90% HRR; n = 7 studies), and intervals of high intensity (85% to 95% peak heart rate or maximal heart rate; n = 3 studies). Most people with stroke did maintain cardiorespiratory fitness in the short- (-0.19 mL/kg/min; 95% CI -1.66 to 1.28), medium- (-0.61 mL/kg/min; 95% CI -3.95 to 2.74), and long-term (0.00 mL/kg/min; 95% CI -2.23 to 2.23) after completion of cardiorespiratory fitness interventions. CONCLUSIONS: People with stroke maintain cardiorespiratory fitness after a cardiorespiratory fitness intervention in the short-, medium-, and longer-term. However, little is known about the impact of participant and intervention characteristics on the long-term maintenance of cardiorespiratory fitness.

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