Rehabilitation interventions for improving balance following stroke: An overview of systematic reviews

Chiara Arienti, Stefano G Lazzarini, Alex Pollock, Stefano Negrini, Chiara Arienti, Stefano G Lazzarini, Alex Pollock, Stefano Negrini

Abstract

Background: The aim of this study was to synthesize evidence from systematic reviews, to summarise the effects of rehabilitation interventions for improving balance in stroke survivors.

Methods: We conducted an overview of systematic reviews (SRs). We included Cochrane Systematic Reviews and non-Cochrane Systematic Reviews of randomized-controlled clinical trials and not-randomized clinical trials, in all types of stroke, comparing the effects of interventions, control interventions and no interventions on balance-related outcomes. We conducted a comprehensive search of electronic databases, from inception to December 2017. Data extracted included: number and type of participants, type of intervention, control intervention, method of assessing risk of bias of primary studies, balance outcome measures and results of statistical meta-analyses. Methodological quality of included reviews was assessed using AMSTAR 2. A narrative description of the characteristics of the SRs was provided and results of meta-analyses summarised with reference to their methodological quality.

Results: 51 SRs (248 primary studies and 10,638 participants) met the inclusion criteria and were included in the overview. All participants were adults with stroke. A wide variety of different balance and postural control outcomes were included. 61% of SRs focussed on the effectiveness of physical therapy, 20% virtual reality, 6% electromechanical devices, 4% Tai-Chi, whole body vibration and circuit training intervention, and 2% cognitive rehabilitation. The methodology of 54% of SRs were judged to be of a "low or critically low" quality, 23% "moderate" quality and 22% "high" quality.

Conclusions: There are 51 SRs of evidence relating to the effectiveness of interventions to improve balance in people with stroke, but the majority of these are of poor methodological quality, limiting our ability to draw clear implications. Only 22% of these SRs were judged to be of high quality, highlighting the need to address important methodological issues within rehabilitation research.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Study flow-chart.
Fig 1. Study flow-chart.
Fig 2. Methodological quality of each rehabilitation…
Fig 2. Methodological quality of each rehabilitation approach.

References

    1. Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC, et al. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2016;47: e98–e169. 10.1161/STR.0000000000000098
    1. Fisher A, Martin J, Srikusalanukul W, Davis M. Trends in stroke survival incidence rates in older Australians in the new millennium and forecasts into the future. J Stroke Cerebrovasc Dis Off J Natl Stroke Assoc. 2014;23: 759–770. 10.1016/j.jstrokecerebrovasdis.2013.06.035
    1. Stroke Association. State of the nation, Stroke statistics, February 2018. Available:
    1. Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet Lond Engl. 2014;383: 245–254.
    1. Ovbiagele B, Nguyen-Huynh MN. Stroke epidemiology: advancing our understanding of disease mechanism and therapy. Neurother J Am Soc Exp Neurother. 2011;8: 319–329. 10.1007/s13311-011-0053-1
    1. Walker MF, Hoffmann TC, Brady MC, Dean CM, Eng JJ, Farrin AJ, et al. Improving the Development, Monitoring and Reporting of Stroke Rehabilitation Research: Consensus-Based Core Recommendations from the Stroke Recovery and Rehabilitation Roundtable. Neurorehabil Neural Repair. 2017;31: 877–884. 10.1177/1545968317732686
    1. Corbetta D, Imeri F, Gatti R. Rehabilitation that incorporates virtual reality is more effective than standard rehabilitation for improving walking speed, balance and mobility after stroke: a systematic review. J Physiother. 2015;61: 117–124. 10.1016/j.jphys.2015.05.017
    1. Beyaert C, Vasa R, Frykberg GE. Gait post-stroke: Pathophysiology and rehabilitation strategies. Neurophysiol Clin Clin Neurophysiol. 2015;45: 335–355. 10.1016/j.neucli.2015.09.005
    1. Wonsetler EC, Bowden MG. A systematic review of mechanisms of gait speed change post-stroke. Part 2: exercise capacity, muscle activation, kinetics, and kinematics. Top Stroke Rehabil. 2017;24: 394–403. 10.1080/10749357.2017.1282413
    1. Boehm WL, Gruben KG. Post-Stroke Walking Behaviors Consistent with Altered Ground Reaction Force Direction Control Advise New Approaches to Research and Therapy. Transl Stroke Res. 2016;7: 3–11. 10.1007/s12975-015-0435-5
    1. Pin-Barre C, Laurin J. Physical Exercise as a Diagnostic, Rehabilitation, and Preventive Tool: Influence on Neuroplasticity and Motor Recovery after Stroke. Neural Plast. 2015;2015: 608581 10.1155/2015/608581
    1. Pollock A, Baer G, Pomeroy V, Langhorne P. Physiotherapy treatment approaches for the recovery of postural control and lower limb function following stroke. Cochrane Database Syst Rev. 2007; CD001920 10.1002/14651858.CD001920.pub2
    1. Lunny C, Brennan SE, McDonald S, McKenzie JE. Toward a comprehensive evidence map of overview of systematic review methods: paper 1-purpose, eligibility, search and data extraction. Syst Rev. 2017;6: 231 10.1186/s13643-017-0617-1
    1. Hunt H, Pollock A, Campbell P, Estcourt L, Brunton G. An introduction to overviews of reviews: planning a relevant research question and objective for an overview. Syst Rev. 2018;7: 39 10.1186/s13643-018-0695-8
    1. Pollock M, Fernandes R, Becker L, Pieper D, Hartling L. Chapter V: Overviews of Reviews. Draft version (8 October 2018) In: Higgins JPT, Thomas J, Chandler J, Cumpston MS, Li T, Page MJ, Welch V (editors). Cochrane Handbook for Systematic Reviews of Interventions. London: Cochrane.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6: e1000097 10.1371/journal.pmed.1000097
    1. Green S, Higgins J, Alderson P, Clarke M, Mulrow C. Chapter 1: What is a systematic review? [updated February 2008]. In: Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions version 5.0.0. The Cochrane Collaboration; 2008. Available: . Accessed 26 May 2009.
    1. Petró B, Papachatzopoulou A, Kiss RM. Devices and tasks involved in the objective assessment of standing dynamic balancing—A systematic literature review. PloS One. 2017;12: e0185188 10.1371/journal.pone.0185188
    1. Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358: j4008 10.1136/bmj.j4008
    1. Whiting P, Savović J, Higgins JPT, Caldwell DM, Reeves BC, Shea B, et al. ROBIS: A new tool to assess risk of bias in systematic reviews was developed. J Clin Epidemiol. 2016;69: 225–234. 10.1016/j.jclinepi.2015.06.005
    1. Banzi R, Cinquini M, Gonzalez-Lorenzo M, Pecoraro V, Capobussi M, Minozzi S. Quality assessment versus risk of bias in systematic reviews: AMSTAR and ROBIS had similar reliability but differed in their construct and applicability. J Clin Epidemiol. 2018;99: 24–32. 10.1016/j.jclinepi.2018.02.024
    1. Pieper D, Puljak L, González-Lorenzo M, Minozzi S. Minor differences were found between AMSTAR 2 and ROBIS in the assessment of systematic reviews including both randomized and nonrandomized studies. J Clin Epidemiol. 2019;108: 26–33. 10.1016/j.jclinepi.2018.12.004
    1. World Confederation for Physical Therapy Policy statement: Description of physical therapy London, UK: WCPT; 2007. Available: . Accessed 10 Mar 2017.
    1. Pollock A, Baer G, Campbell P, Choo PL, Forster A, Morris J, et al. Physical rehabilitation approaches for the recovery of function and mobility following stroke. Cochrane Database Syst Rev. 2014; CD001920 10.1002/14651858.CD001920.pub3
    1. Saunders DH, Sanderson M, Hayes S, Kilrane M, Greig CA, Brazzelli M, et al. Physical fitness training for stroke patients. Cochrane Database Syst Rev. 2016;3: CD003316 10.1002/14651858.CD003316.pub6
    1. French B, Thomas LH, Coupe J, McMahon NE, Connell L, Harrison J, et al. Repetitive task training for improving functional ability after stroke. Cochrane Database Syst Rev. 2016;11: CD006073 10.1002/14651858.CD006073.pub3
    1. Vloothuis JD, Mulder M, Veerbeek JM, Konijnenbelt M, Visser-Meily JM, Ket JC, et al. Caregiver-mediated exercises for improving outcomes after stroke. Cochrane Database Syst Rev. 2016;12: CD011058 10.1002/14651858.CD011058.pub2
    1. Lawrence M, Celestino Junior FT, Matozinho HH, Govan L, Booth J, Beecher J. Yoga for stroke rehabilitation. Cochrane Database Syst Rev. 2017;12: CD011483 10.1002/14651858.CD011483.pub2
    1. Mehrholz J, Kugler J, Pohl M. Water-based exercises for improving activities of daily living after stroke. Cochrane Database Syst Rev. 2011; CD008186 10.1002/14651858.CD008186.pub2
    1. English C, Hillier SL, Lynch EA. Circuit class therapy for improving mobility after stroke. Cochrane Database Syst Rev. 2017;6: CD007513 10.1002/14651858.CD007513.pub3
    1. Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64: 383–394. 10.1016/j.jclinepi.2010.04.026
    1. Pollock A, Hazelton C, Henderson CA, Angilley J, Dhillon B, Langhorne P, et al. Interventions for disorders of eye movement in patients with stroke. Cochrane Database Syst Rev. 2011; CD008389 10.1002/14651858.CD008389.pub2
    1. Pollock A, Hazelton C, Henderson CA, Angilley J, Dhillon B, Langhorne P, et al. Interventions for visual field defects in patients with stroke. Cochrane Database Syst Rev. 2011; CD008388 10.1002/14651858.CD008388.pub2
    1. Laver KE, Lange B, George S, Deutsch JE, Saposnik G, Crotty M. Virtual reality for stroke rehabilitation. Cochrane Database Syst Rev. 2017;11: CD008349 10.1002/14651858.CD008349.pub4
    1. Bowen A, Hazelton C, Pollock A, Lincoln NB. Cognitive rehabilitation for spatial neglect following stroke. Cochrane Database Syst Rev. 2013; CD003586 10.1002/14651858.CD003586.pub3
    1. van Duijnhoven HJR, Heeren A, Peters MAM, Veerbeek JM, Kwakkel G, Geurts ACH, et al. Effects of Exercise Therapy on Balance Capacity in Chronic Stroke: Systematic Review and Meta-Analysis. Stroke. 2016;47: 2603–2610. 10.1161/STROKEAHA.116.013839
    1. Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurol. 2009;8: 741–754. 10.1016/S1474-4422(09)70150-4
    1. Tyson SF, Kent RM. Effects of an ankle-foot orthosis on balance and walking after stroke: a systematic review and pooled meta-analysis. Arch Phys Med Rehabil. 2013;94: 1377–1385. 10.1016/j.apmr.2012.12.025
    1. Stoller O, de Bruin ED, Knols RH, Hunt KJ. Effects of cardiovascular exercise early after stroke: systematic review and meta-analysis. BMC Neurol. 2012;12: 45 10.1186/1471-2377-12-45
    1. Veerbeek JM, van Wegen E, van Peppen R, van der Wees PJ, Hendriks E, Rietberg M, et al. What is the evidence for physical therapy poststroke? A systematic review and meta-analysis. PloS One. 2014;9: e87987 10.1371/journal.pone.0087987
    1. Van Criekinge T, Saeys W, Vereeck L, De Hertogh W, Truijen S. Are unstable support surfaces superior to stable support surfaces during trunk rehabilitation after stroke? A systematic review. Disabil Rehabil. 2018;40: 1981–1988. 10.1080/09638288.2017.1323030
    1. Barclay-Goddard R, Stevenson T, Poluha W, Moffatt MEK, Taback SP. Force platform feedback for standing balance training after stroke. Cochrane Database Syst Rev. 2004; CD004129 10.1002/14651858.CD004129.pub2
    1. Bonini-Rocha AC, de Andrade ALS, Moraes AM, Gomide Matheus LB, Diniz LR, Martins WR. Effectiveness of Circuit-Based Exercises on Gait Speed, Balance, and Functional Mobility in People Affected by Stroke: A Meta-Analysis. PM R. 2018;10: 398–409. 10.1016/j.pmrj.2017.09.014
    1. de Rooij IJM, van de Port IGL, Meijer J-WG. Effect of Virtual Reality Training on Balance and Gait Ability in Patients With Stroke: Systematic Review and Meta-Analysis. Phys Ther. 2016;96: 1905–1918. 10.2522/ptj.20160054
    1. Li Z, Han X-G, Sheng J, Ma S-J. Virtual reality for improving balance in patients after stroke: A systematic review and meta-analysis. Clin Rehabil. 2016;30: 432–440. 10.1177/0269215515593611
    1. Chen B-L, Guo J-B, Liu M-S, Li X, Zou J, Chen X, et al. Effect of Traditional Chinese Exercise on Gait and Balance for Stroke: A Systematic Review and Meta-Analysis. PloS One. 2015;10: e0135932 10.1371/journal.pone.0135932
    1. Yang X, Wang P, Liu C, He C, Reinhardt JD. The effect of whole body vibration on balance, gait performance and mobility in people with stroke: a systematic review and meta-analysis. Clin Rehabil. 2015;29: 627–638. 10.1177/0269215514552829
    1. Sorinola IO, Powis I, White CM. Does additional exercise improve trunk function recovery in stroke patients? A meta-analysis. NeuroRehabilitation. 2014;35: 205–213. 10.3233/NRE-141123
    1. Tang A, Tao A, Soh M, Tam C, Tan H, Thompson J, et al. The effect of interventions on balance self-efficacy in the stroke population: a systematic review and meta-analysis. Clin Rehabil. 2015;29: 1168–1177. 10.1177/0269215515570380
    1. Hancock NJ, Shepstone L, Winterbotham W, Pomeroy V. Effects of lower limb reciprocal pedalling exercise on motor function after stroke: a systematic review of randomized and nonrandomized studies. Int J Stroke Off J Int Stroke Soc. 2012;7: 47–60. 10.1111/j.1747-4949.2011.00728.x
    1. An M, Shaughnessy M. The effects of exercise-based rehabilitation on balance and gait for stroke patients: a systematic review. J Neurosci Nurs J Am Assoc Neurosci Nurses. 2011;43: 298–307. 10.1097/JNN.0b013e318234ea24
    1. Wist S, Clivaz J, Sattelmayer M. Muscle strengthening for hemiparesis after stroke: A meta-analysis. Ann Phys Rehabil Med. 2016;59: 114–124. 10.1016/j.rehab.2016.02.001
    1. Van Peppen RPS, Kwakkel G, Wood-Dauphinee S, Hendriks HJM, Van der Wees PJ, Dekker J. The impact of physical therapy on functional outcomes after stroke: what’s the evidence? Clin Rehabil. 2004;18: 833–862. 10.1191/0269215504cr843oa
    1. Ko D-S, Jung D-I, Bae S-Y. Effect of lumbar stabilization exercises on the balance ability of patients with stroke: a systematic review. J Phys Ther Sci. 2014;26: 1993–1996. 10.1589/jpts.26.1993
    1. Cabanas-Valdés R, Cuchi GU, Bagur-Calafat C. Trunk training exercises approaches for improving trunk performance and functional sitting balance in patients with stroke: a systematic review. NeuroRehabilitation. 2013;33: 575–592. 10.3233/NRE-130996
    1. Chen L, Chen J, Peng Q, Chen J, Zou Y, Liu G. Effect of Sling Exercise Training on Balance in Patients with Stroke: A Meta-Analysis. PloS One. 2016;11: e0163351 10.1371/journal.pone.0163351
    1. Lubetzky-Vilnai A, Kartin D. The effect of balance training on balance performance in individuals poststroke: a systematic review. J Neurol Phys Ther JNPT. 2010;34: 127–137. 10.1097/NPT.0b013e3181ef764d
    1. Bank J, Charles K, Morgan P. What is the effect of additional physiotherapy on sitting balance following stroke compared to standard physiotherapy treatment: a systematic review. Top Stroke Rehabil. 2016;23: 15–25. 10.1179/1945511915Y.0000000005
    1. Hammer A, Nilsagård Y, Wallquist M. Balance training in stroke patients–a systematic review of randomized, controlled trials. Adv Physiother. 2008;10: 163–172. 10.1080/14038190701757656
    1. Kollen BJ, Lennon S, Lyons B, Wheatley-Smith L, Scheper M, Buurke JH, et al. The effectiveness of the Bobath concept in stroke rehabilitation: what is the evidence? Stroke. 2009;40: e89–97. 10.1161/STROKEAHA.108.533828
    1. Wang X-Q, Pi Y-L, Chen B-L, Chen P-J, Liu Y, Wang R, et al. Cognitive motor interference for gait and balance in stroke: a systematic review and meta-analysis. Eur J Neurol. 2015;22: 555–e37. 10.1111/ene.12616
    1. Van Peppen RPS, Kortsmit M, Lindeman E, Kwakkel G. Effects of visual feedback therapy on postural control in bilateral standing after stroke: a systematic review. J Rehabil Med. 2006;38: 3–9.
    1. Wevers L, van de Port I, Vermue M, Mead G, Kwakkel G. Effects of task-oriented circuit class training on walking competency after stroke: a systematic review. Stroke. 2009;40: 2450–2459. 10.1161/STROKEAHA.108.541946
    1. Chen L, Lo WLA, Mao YR, Ding MH, Lin Q, Li H, et al. Effect of Virtual Reality on Postural and Balance Control in Patients with Stroke: A Systematic Literature Review. BioMed Res Int. 2016;2016: 7309272 10.1155/2016/7309272
    1. Luque-Moreno C, Ferragut-Garcías A, Rodríguez-Blanco C, Heredia-Rizo AM, Oliva-Pascual-Vaca J, Kiper P, et al. A Decade of Progress Using Virtual Reality for Poststroke Lower Extremity Rehabilitation: Systematic Review of the Intervention Methods. BioMed Res Int. 2015;2015: 342529 10.1155/2015/342529
    1. Cheok G, Tan D, Low A, Hewitt J. Is Nintendo Wii an Effective Intervention for Individuals With Stroke? A Systematic Review and Meta-Analysis. J Am Med Dir Assoc. 2015;16: 923–932. 10.1016/j.jamda.2015.06.010
    1. Dos Santos LRA, Carregosa AA, Masruha MR, Dos Santos PA, Da Silveira Coêlho ML, Ferraz DD, et al. The Use of Nintendo Wii in the Rehabilitation of Poststroke Patients: A Systematic Review. J Stroke Cerebrovasc Dis Off J Natl Stroke Assoc. 2015;24: 2298–2305. 10.1016/j.jstrokecerebrovasdis.2015.06.010
    1. Iruthayarajah J, McIntyre A, Cotoi A, Macaluso S, Teasell R. The use of virtual reality for balance among individuals with chronic stroke: a systematic review and meta-analysis. Top Stroke Rehabil. 2017;24: 68–79. 10.1080/10749357.2016.1192361
    1. Chen J, Jin W, Zhang X-X, Xu W, Liu X-N, Ren C-C. Telerehabilitation Approaches for Stroke Patients: Systematic Review and Meta-analysis of Randomized Controlled Trials. J Stroke Cerebrovasc Dis Off J Natl Stroke Assoc. 2015;24: 2660–2668. 10.1016/j.jstrokecerebrovasdis.2015.09.014
    1. Tally Z, Boetefuer L, Kauk C, Perez G, Schrand L, Hoder J. The efficacy of treadmill training on balance dysfunction in individuals with chronic stroke: a systematic review. Top Stroke Rehabil. 2017;24: 539–546. 10.1080/10749357.2017.1345445
    1. Swinnen E, Beckwée D, Meeusen R, Baeyens J-P, Kerckhofs E. Does robot-assisted gait rehabilitation improve balance in stroke patients? A systematic review. Top Stroke Rehabil. 2014;21: 87–100. 10.1310/tsr2102-87
    1. Lin S, Sun Q, Wang H, Xie G. Influence of transcutaneous electrical nerve stimulation on spasticity, balance, and walking speed in stroke patients: A systematic review and meta-analysis. J Rehabil Med. 2018;50: 3–7. 10.2340/16501977-2266
    1. Lu J, Xu G, Wang Y. Effects of whole body vibration training on people with chronic stroke: a systematic review and meta-analysis. Top Stroke Rehabil. 2015;22: 161–168. 10.1179/1074935714Z.0000000005
    1. Ge L, Zheng Q-X, Liao Y-T, Tan J-Y, Xie Q-L, Rask M. Effects of traditional Chinese exercises on the rehabilitation of limb function among stroke patients: A systematic review and meta-analysis. Complement Ther Clin Pract. 2017;29: 35–47. 10.1016/j.ctcp.2017.08.005
    1. Murad MH, Montori VM, Ioannidis JPA, Jaeschke R, Devereaux PJ, Prasad K, et al. How to read a systematic review and meta-analysis and apply the results to patient care: users’ guides to the medical literature. JAMA. 2014;312: 171–179. 10.1001/jama.2014.5559
    1. Armijo-Olivo S, da Costa BR, Cummings GG, Ha C, Fuentes J, Saltaji H, et al. PEDro or Cochrane to Assess the Quality of Clinical Trials? A Meta-Epidemiological Study. PloS One. 2015;10: e0132634 10.1371/journal.pone.0132634
    1. Olivo SA, Macedo LG, Gadotti IC, Fuentes J, Stanton T, Magee DJ. Scales to assess the quality of randomized controlled trials: a systematic review. Phys Ther. 2008;88: 156–175. 10.2522/ptj.20070147
    1. Higgins J, Altman D. Chapter 8: Assessing risk of bias in included studies In: Higgins J, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions version 50. Chichester, UK: John Wiley & Sons, Ltd; 2008.
    1. Herbert R, Moseley A, Sherrington C. PEDro: a database of randomised controlled trials in physiotherapy. Health Inf Manag J Health Inf Manag Assoc Aust. 1998;28: 186–188.
    1. da Costa BR, Hilfiker R, Egger M. PEDro’s bias: summary quality scores should not be used in meta-analysis. J Clin Epidemiol. 2013;66: 75–77. 10.1016/j.jclinepi.2012.08.003
    1. Armijo-Olivo S, Fuentes J, Ospina M, Saltaji H, Hartling L. Inconsistency in the items included in tools used in general health research and physical therapy to evaluate the methodological quality of randomized controlled trials: a descriptive analysis. BMC Med Res Methodol. 2013;13: 116 10.1186/1471-2288-13-116
    1. Gillespie DC, Bowen A, Chung CS, Cockburn J, Knapp P, Pollock A. Rehabilitation for post-stroke cognitive impairment: an overview of recommendations arising from systematic reviews of current evidence. Clin Rehabil. 2015;29: 120–128. 10.1177/0269215514538982
    1. Lunny C, Brennan SE, McDonald S, McKenzie JE. Toward a comprehensive evidence map of overview of systematic review methods: paper 2-risk of bias assessment; synthesis, presentation and summary of the findings; and assessment of the certainty of the evidence. Syst Rev. 2018;7: 159 10.1186/s13643-018-0784-8
    1. Lunny C, Brennan SE, McDonald S, McKenzie JE. Evidence map of studies evaluating methods for conducting, interpreting and reporting overviews of systematic reviews of interventions: rationale and design. Syst Rev. 2016;5: 4 10.1186/s13643-015-0178-0
    1. Wu S, Chen J, Wang S, Jiang M, Wang X, Wen Y. Effect of Tai Chi Exercise on Balance Function of Stroke Patients: A Meta-Analysis. Med Sci Monit Basic Res. 2018;24: 210–215. 10.12659/MSMBR.911951
    1. Louie DR, Lim SB, Eng JJ. The Efficacy of Lower Extremity Mirror Therapy for Improving Balance, Gait, and Motor Function Poststroke: A Systematic Review and Meta-Analysis. J Stroke Cerebrovasc Dis Off J Natl Stroke Assoc. 2019;28: 107–120. 10.1016/j.jstrokecerebrovasdis.2018.09.017
    1. Zou L, Yeung A, Li C, Chiou S-Y, Zeng N, Tzeng H-M, et al. Effects of Mind−Body Movements on Balance Function in Stroke Survivors: A Meta-Analysis of Randomized Controlled Trials. Int J Environ Res Public Health. 2018;15 10.3390/ijerph15061292
    1. Broderick P, Horgan F, Blake C, Ehrensberger M, Simpson D, Monaghan K. Mirror therapy for improving lower limb motor function and mobility after stroke: A systematic review and meta-analysis. Gait Posture. 2018;63: 208–220. 10.1016/j.gaitpost.2018.05.017
    1. Li GY, Wang W, Liu GL, Zhang Y. Effects of Tai Chi on balance and gait in stroke survivors: A systematic meta-analysis of randomized controlled trials. J Rehabil Med. 2018;50: 582–588. 10.2340/16501977-2346
    1. Schröder J, Truijen S, Van Criekinge T, Saeys W. Peripheral somatosensory stimulation and postural recovery after stroke—a systematic review. Top Stroke Rehabil. 2018;25: 312–320. 10.1080/10749357.2018.1440694
    1. Pollock A, Hazelton C, Rowe FJ, Jonuscheit S, Kernohan A, Angilley J, et al. Interventions for visual field defects in people with stroke. Cochrane Database Syst Rev. 2019;5: CD008388 10.1002/14651858.CD008388.pub3

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren