Abstract
ObjectiveThis study aims to evaluate the effect of sling exercise training (SET) on balance in patients with stroke.MethodsPubMed, Cochrane Library, Ovid LWW, CBM, CNKI, WanFang, and VIP databases were searched for randomized controlled trials of the effect of SET on balance in patients with stroke. The study design and participants were subjected to metrological analysis. Berg balance Scale (BBS), Barthel index score (BI), and Fugl-Meyer Assessment (FMA) were used as independent parameters for evaluating balance function, activities of daily living(ADL) and motor function after stroke respectively, and were subjected to meta-analysis by RevMan5.3 software.ResultsNine studies with 460 participants were analyzed. Results of meta-analysis showed that the SET treatment combined with conventional rehabilitation was superior to conventional rehabilitation treatments, with increased degrees of BBS (WMD = 3.81, 95% CI [0.15, 7.48], P = 0.04), BI (WMD = 12.98, 95% CI [8.39, 17.56], P < 0.00001), and FMA (SMD = 0.76, 95% CI [0.41, 1.11], P < 0.0001).ConclusionBased on limited evidence from 9 trials, the SET treatment combined with conventional rehabilitation was superior to conventional rehabilitation treatments, with increased degrees of BBS, BI and FMA, So the SET treatment can improvement of balance function after stroke, but the interpretation of our findings is required to be made with caution due to limitations in included trials such as small sample sizes and the risk of bias. Therefore, more multi-center and large-sampled randomized controlled trials are needed to confirm its clinical applications.
Highlights
Stroke is a prevalent health problem and is one of the most common causes of acquired disability and death in adults[1, 2]
Results of meta-analysis showed that the sling exercise training (SET) treatment combined with conventional rehabilitation was superior to conventional rehabilitation treatments, with increased degrees of Berg balance Scale (BBS) (WMD = 3.81, 95% confidence intervals (CI) [0.15, 7.48], P = 0.04), Barthel index score (BI) (WMD = 12.98, 95% CI [8.39, 17.56], P < 0.00001), and Fugl-Meyer Assessment (FMA) (SMD = 0.76, 95% CI [0.41, 1.11], P < 0.0001)
1 Study design: All randomized controlled studies (RCTs) on the effect of the SET treatment combined with conventional rehabilitation compared with conventional rehabilitation treatments published in Chinese or English were included in this analysis
Summary
Stroke is a prevalent health problem and is one of the most common causes of acquired disability and death in adults[1, 2]. Confidence for patients returning their home life is affected. All these inconvenience resulting from stroke causes great burdens[4,5,6]. Common treatments for balance dysfunction include trunk muscle training exercises[1,2], mental imagery[7], functional electrical stimulation[8], motor relearning program[9], etc. Trunk muscle training exercises are the most commonly used clinical treatments because these activities strengthen core muscle functions and promotes recovery of balance function after stroke[10,11]. Intensive training on unstable support surfaces can enhance the stability of core muscles and enlarge the cross-sectional area of muscles, thereby increasing discharge frequency and numbers of motor unit. Unstable support training can be used to significantly improve balance than training on stable support surfaces[12,13,14]
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