Research Background: Stroke rehabilitation is essential for improving patient outcomes, with a focus on restoring functionality, strength, and mobility. Aerobic (TAE) and anaerobic (TAN) training have demonstrated varying impacts on post-stroke recovery. Objective: This systematic review and meta-analysis aimed to compare the effects of TAE and TAN on post-stroke rehabilitation outcomes, including functionality, walking improvement, strength, balance, and cardiorespiratory capacity. Methods: A comprehensive literature search was conducted in the PubMed and PEDro databases, covering studies from January 2014 to May 2024. Randomized controlled trials (RCTs) evaluating the impact of TAE and TAN on the specified outcomes were included. The review adhered to PRISMA guidelines, and independent reviewers extracted relevant data on participant characteristics, interventions, and outcomes. The methodological quality of the included studies was assessed using the PEDro scale, and the risk of bias was analyzed. Results: Data synthesis revealed that TAN was more effective in improving performance in the 10-Meter Walk Test (10MWT) and the Berg Balance Scale (BBS), while TAE demonstrated superior results in the Timed Up and Go (TUG) test and the Barthel Activities of Daily Living Index (Barthel ADL). Both training modalities showed significant improvements in the 6-Minute Walk Test (6MWT) for cardiorespiratory capacity, with TAN exhibiting a slightly higher mean difference. Surprisingly, strength gains, assessed by Maximal Isometric Strength (MaxIS), were higher in the TAE group. Conclusions: Both TAE and TAN contribute to post-stroke recovery, with TAN excelling in walking and balance improvements, and TAE showing advantages in functional mobility and strength. The findings support personalized rehabilitation strategies that incorporate both aerobic and anaerobic training to optimize patient outcomes.
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