Limited evidence of physical therapy on balance after stroke: A systematic review and meta-analysis

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dc.authoridOzdemir, Yeliz Bahar / 0000-0003-2253-3767
dc.authoridSzulc, Pawel / 0000-0003-4168-6697
dc.authoridARDAILLON, Hugo / 0000-0002-4113-2427
dc.authoridHugues, Aurelien / 0000-0001-9190-2867
dc.authoridPires, Jennifer / 0000-0001-5141-5853
dc.authorwosidCharvat, Hadrien / AAJ-1910-2021
dc.authorwosidOzdemir, Yeliz Bahar / AAT-3595-2020
dc.authorwosidKhademi, Hooman / AAZ-8798-2020
dc.contributor.authorHugues, Aurelien
dc.contributor.authorDi Marco, Julie
dc.contributor.authorRibault, Shams
dc.contributor.authorArdaillon, Hugo
dc.contributor.authorJaniaud, Perrine
dc.contributor.authorXue, Yufeng
dc.contributor.authorRode, Gilles
dc.date.accessioned2021-11-01T15:02:59Z
dc.date.available2021-11-01T15:02:59Z
dc.date.issued2019
dc.department[Belirlenecek]
dc.description.abstractBackground Stroke results in balance disorders and these directly affect autonomy and quality of life. The purpose of this systematic review and meta-analysis was to determine the efficacy of physical therapy (PT) on balance and postural control after stroke. Methods We included all randomized controlled trials assessing the efficacy of PT on balance and postural control in adult patients after stroke without language restriction. Medline, Embase/Scopus, Cochrane Central Register of Controlled Trials, PEDro, Pascal, and Francis databases were searched until January 2019. Primary outcomes were balance (Berg Balance scale and Postural Assessment Scale for Stroke) and postural control with postural deviation or stability measurement in sitting or standing static evaluation. A pair of independent reviewers selected studies, extracted data, and assessed risk of bias. Meta-analyses with subgroups (categories of PT, time post-stroke, and lesion location) and meta-regression (duration of PT) were conducted. Results A total of 145 studies (n = 5912) were selected from the 13,123 records identified. For balance, evidence was found in favor of the efficacy of functional task-training alone (standardized mean difference 0.39, 95% confidence interval [0.09; 0.68], heterogeneity I-2 = 63%) or associated with musculoskeletal intervention and/or cardiopulmonary intervention (0.37, [0.19; 0.55], I-2 = 48%), electrostimulation (0.91, [0.49; 1.34], I-2 = 52%) immediately after intervention, compared to sham treatment or usual care (ST/UC). For postural deviation eyes open, assistive devices were more effective than no treatment (-0.21, [-0.37; -0.05], I-2 = 0%) immediately after intervention; for postural stability eyes open, functional task-training and sensory interventions were more effective than ST/UC (0.97, [0.35; 1.59], I-2 = 65% and 0.80, [0.46; 1.13], I-2 = 37% respectively) immediately after intervention. Conclusions Functional task-training associated with musculoskeletal intervention and/or cardiopulmonary intervention and sensory interventions seem to be immediately effective in improving balance and postural stability, respectively. The heterogeneity of PT and the weak methodological quality of studies limited the interpretation and the confidence in findings.
dc.description.sponsorshipWorld Health OrganizationWorld Health Organization [001] Funding Source: Medlineen_US
dc.identifier.doi10.1371/journal.pone.0221700
dc.identifier.issn1932-6203
dc.identifier.issue8en_US
dc.identifier.pmid31465462
dc.identifier.scopus2-s2.0-85071401583
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://doi.org/10.1371/journal.pone.0221700
dc.identifier.urihttps://hdl.handle.net/11491/6905
dc.identifier.volume14en_US
dc.identifier.wosWOS:000485058200037
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthor[Belirlenecek]
dc.language.isoen
dc.publisherPublic Library Science
dc.relation.ispartofPlos One
dc.relation.publicationcategoryDiğer
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subject[No Keywords]en_US
dc.titleLimited evidence of physical therapy on balance after stroke: A systematic review and meta-analysis
dc.typeReview Article

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