The Effects of Unstable Surface Training on Balance and Gait in Stroke Patients: A Systematic Review and Meta-Analysis

The Effects of Unstable Surface Training on Balance and Gait in Stroke Patients: A Systematic Review and Meta-Analysis

Objective: Stroke patients need the training to adjust their posture and maintain balance is necessary to restore movement function, and unstable support training is one of the appropriate training. In this study, a systematic review and meta-analysis were conducted to find out the effects of unstable surface training on balance and gait in stroke patients. Design: Systematic review and meta-analysisMethods: After creating a search expression referring to MeSH and EMTREE, the literature from 1976 to February 2022 was searched in the databases of PubMed, EMBASE, and Cochrane Library CENTRAL. A total of 331 studies were searched from three databases, and 11 studies were finally selected according to the inclusion criteria. Unstable surface training included studies using balance trainer, Whole-body vibration, and sand surfaces. Results: The results were found to be d＝2.28 (p＝0.02) and the effect size was 0.36 (95% CI: 0.05, 0.67) on the Berg Balance Scale. In the Kinesthetic Ability Trainer static balance, d＝2.59 (p＝0.01) and the effect size was 1.01 (95% CI: 0.24, 1.78). Timed Up and Go test showed that d＝2.18 (p＝0.03) and the effect size was 0.38 (95% CI: 0.04, 0.72). At the gait speed, d＝0.99 (p＝ 0.32) and the effect size was 0.15 (95% CI: -0.15, 0.45). In the 6-minute walk test, d＝0.14 (p＝0.89) and the effect size was 0.04 (95% CI: －0.47, 0.55). Conclusions: In this study was found that training was effective in balance if it became unstable in standing posture. Therefore, unstable surface training can be used to improve the balance of stroke patients in clinical practice.