Effects of rehabilitation exercise program types on dynamic balance in patients with stroke: a meta-analysis of randomized controlled trials

ABSTRACT

Purpose

The purposes of meta-analysis are to evaluate evidence about the effects of Rehabilitation Exercise Program on the balance of post-stroke patients, evaluated by the Berg Balance Scale (BBS).

Methods

The search was conducted ‘stroke,’ ‘rehabilitation,’ ‘dynamic balance,’ ‘Berg Balance Scale,’ ‘exercise’ and ‘randomized controlled trial’using MEDLINE (accessed by PubMed), Web of Science (WoS), ProQuest, and Google Scholar for journal studies published from January 2018 to October 2022. Two independent reviewers performed the article selection, data extraction, and methodological quality assessment. The main outcome was dynamic balance assessed by the Berg Balance scale.

Results

The review included 30 papers and a total of 540 patients. The overall effect size was 0.550, a medium effect size according to the Cohen’s standard. It was observed that gender has moderate effect size in male (0.551), female (0.458) and higher in male. Exercise type results showed large effect sizes in balance training (0.966), and aquatic activities (0.830), moderate effect sizes in virtual reality (0.762), moderate effect sizes in physically active (0.581), gait training (0.541), dual-task (0.478), trunk control (0.284), and small effect sizes in resistance training (0.128).

Conclusions

Exercise programs are effective in improving dynamic balance in stroke patients. Especially, the meta-analysis showed higher Effect Size for balance training and virtual reality than for other programs making this relevant interventions for future head to head superiority studies that compare different balance interventions in stroke.

KEYWORDS:

• Stroke
• dynamic balance
• rehabilitation
• exercise
• meta-analysis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10749357.2024.2329849

Additional information

Funding

This study was supported by the Translational R&D Program on Smart Rehabilitation Exercises(#TRSRE-PS01)*, National Rehabilitation Center, Ministry of Health and Welfare, Korea.