Effect of Traditional Chinese Exercise on Gait and Balance for Stroke: A Systematic Review and Meta-Analysis

Bing-Lin Chen, Jia-Bao Guo, Ming-Shuo Liu, Xin Li, Jun Zou, Xi Chen, Ling-Li Zhang, Yu-Shan Yue, Xue-Qiang Wang, Bing-Lin Chen, Jia-Bao Guo, Ming-Shuo Liu, Xin Li, Jun Zou, Xi Chen, Ling-Li Zhang, Yu-Shan Yue, Xue-Qiang Wang

Abstract

Objective: A systematic review is conducted to determine the effect of traditional Chinese exercise for patients with stroke.

Methods: Studies are obtained from PubMed, Embase, Cochrane Library, EBSCO, Web of Science, and CNKI. Only randomized controlled trials were left to evaluate the effects of traditional Chinese exercise for patients with stroke, and with no limits on study data or language. The primary outcome was the Berg balance score (BBS), Functional walking scale. And a random-effects model was used to calculate the pooled mean difference (MD) with 95% confidence interval (CI).

Results: A total of 9 studies on 820 participants conform to the inclusion criteria, whereas eight studies on 704 participants are used as data sources for the meta-analysis, all trials were published between 2004 and 2013. The BBS indicates that the efficacy of traditional Chinese exercise on balance of patients with stroke is better than that of other training or no training in short term [MD (95%CI) = 11.85 [5.41, 18.30], P < 0.00001]. And the short physical performance battery, Functional walking scale, limit of stability were observed significant differences on balance (p<0.05) and gait (p<0.05) between traditional Chinese exercise and other exercises or no exercise. In addition, there is an article showed that some other form (physiotherapy exercises focused on balance) significantly improved balance ability for stroke patients compared to tai chi chuan practice (Berg test = 0.01, Romberg, and standing on one leg).

Conclusion: In our meta analysis, the positive findings of this study suggest traditional Chinese exercise has beneficial effects on the balance ability in short term. However, we drew the conclusion according to the extreme heterogeneity, and evidence of better quality and from a larger sample size is required. Because of the inconsistent outcomes, there are short of enough good evidence for patients with stroke to prove the effects of traditional Chinese exercise on gait.

Systematic review registration: http://www.crd.york.ac.uk/PROSPERO PROSPERO registration number: CRD42013006474.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Flow chart of the study…
Fig 1. Flow chart of the study selection procedure.
For details of study identification.
Fig 2. Forest plot for traditional Chinese…
Fig 2. Forest plot for traditional Chinese exercise on balance in short term.
Short term: not longer than 3 months; BBS = Berg balance score; SD = standard deviation; 95% CI = 95% confidence intervals; IV = inverse variance.
Fig 3. Funnel plot for traditional Chinese…
Fig 3. Funnel plot for traditional Chinese exercise on balance in short term.
Short term: not longer than 3 months.

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