Vestibular rehabilitation therapy on balance and gait in patients after stroke: a systematic review and meta-analysis

BMC Medicine

Research Article

Siyi Li¹  Lijiao Meng²  Qiu Liang²  Quan Wei²  Jingyi Yang²  Yanlei Ge²  Jianrong Yuan³  Raymond C C Tsang⁴ 

[1] Department of Rehabilitation Medicine and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, 610041, Chengdu, Sichuan, China;Department of Rehabilitation Medicine and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, 610041, Chengdu, Sichuan, China;Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, 610041, Chengdu, Sichuan, China;Department of Rehabilitation Medicine, Chongqing University Three Gorges Hospital, No. 165. Xin Cheng Road, Chongqing, China;Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, No. 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong, China;

关键词: Vestibular rehabilitation;    Stroke;    Balance;    Gait;    Systematic review;    Meta-analysis;   

DOI  :  10.1186/s12916-023-03029-9

 received in 2023-06-24, accepted in 2023-08-14,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThere is limited evidence to support the use of vestibular rehabilitation therapy (VRT) on improving balance and gait in patients after stroke. This systematic review aimed to evaluate the effects of VRT in addition to usual rehabilitation compared with usual rehabilitation on improving balance and gait for patients after stroke.MethodsThis review followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis statement guidelines. Ten electronic databases were searched up to 1 June 2023 without restrictions in language and publication status. The PEDro scale and the Grading of Recommendations Assessment Development, and Evaluation were used to evaluate the risk of bias and the certainty of evidence. The meta-analysis was conducted with Review Manager 5.3.ResultsFifteen randomised controlled trials with 769 participants were included. PEDro scale was used to assess the risk of bias with a mean score of 5.9 (0.7). VRT was effective in improving balance for patients after stroke (SMD = 0.59, 95% CI (0.40, 0.78), p < 0.00001), particularly for patients after stroke that occurred within 6 months (SMD = 0.56, 95% CI (0.33, 0.79), p < 0.00001) with moderate certainty of evidence. Subgroup analysis showed that VRT provided as gaze stability exercises combined with swivel chair training (SMD = 0.85, 95% CI (0.48, 1.22), p < 0.00001) and head movements (SMD = 0.75, 95% CI (0.43, 1.07), p < 0.00001) could significantly improve balance. Four-week VRT had better effect on balance improvement (SMD = 0.64, 95% CI (0.40, 0.89), p < 0.00001) than the less than 4-week VRT. The pooled mean difference of values of Timed Up-and-Go test showed that VRT could significantly improve gait function for patients after stroke (MD =  −4.32, 95% CI (−6.65, −1.99), p = 0.0003), particularly for patients after stroke that occurred within 6 months (MD =  −3.92, 95% CI (−6.83, −1.00), p = 0.008) with moderate certainty of evidence.ConclusionsThere is moderate certainty of evidence supporting the positive effect of VRT in improving balance and gait of patients after stroke.Trial registrationPROSPERO CRD42023434304

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 4

Fig. 5

Fig. 2

Fig. 4

Fig. 2

Fig. 5