The Safety and Efficacy of Balance Training on Stroke Patients With Reduced Balance Ability: A Meta-Analysis of Randomized Controlled Trials

Abstract

To investigate the safety and efficacy of balance training for stroke patients with reduced balance ability by performing a meta-analysis of randomized controlled trials. The PubMed, Embase, and Cochrane Central Register of Controlled Trials databases were searched up to February 2022. Quality assessment was performed using the using the Cochrane risk of bias tool. Studies were included if: 1) patient allocation was randomized; 2) the participant was composed of stroke patients with reduced balance ability (Berg Balance Scale [BBS] ≤ 40, Timed-Up and Go ≥ 14 seconds, or Mini-Balance Evaluation Systems Test ≤ 17.5); and 3) intervention was additional balance training for the experimental group. Six studies including 466 patients were included in the final analysis. The meta-analysis showed a significant improvement in the BBS (mean difference [MD], 8.14; 95% confidence interval [CI], 4.65, 11.64) and Trunk Impairment Scale (MD, 4.71; 95% CI, 3.45, 5.96) after balance training relative to the comparison group. Ambulation function was significantly improved (standardized MD, 0.98; 95% CI, 0.46, 1.49) after balance training. There was one report of a femur fracture among 230 participants in the balance training group. Balance training in addition to conventional rehabilitation program in stroke patients with reduced balance ability appears to be effective and safe.