Effectiveness of walking training on balance, motor functions, activity, participation and quality of life in people with chronic stroke: a systematic review with meta-analysis and meta-regression of recent randomized controlled trials

Nindorera, Félix; Nduwimana, Ildéphonse; Thonnard, Jean Louis; Kossi, Oyéné

doi:10.1080/09638288.2021.1894247

Cited by 22 publications

(17 citation statements)

References 59 publications

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“…The overall effect from the meta-analysis indicates that CBR had an effect (nonsignificant) on walking capacity and balance. This effect can be understood from the positive relationship reported between balance and functional independence in people post stroke ( Langhammer et al, 2008;Kossi et al, 2019;Nindorera et al, 2021). Moreover, previous studies have identified the predictive value of specific types of scales on activities of daily living (walking) after a stroke (Naidoo, 2010;Fu et al, 2020).…”

Section: Discussionmentioning

confidence: 94%

“…Loss of balance while walking is common after stroke (Chang et al, 2021;Kossi et al, 2021), with about 70% of people living at home post stroke reporting a fall within a year of their stroke (Beyaert et al, 2015;Kossi et al, 2021). Limited walking capacity restricts the person's independent mobility and can contribute to a sedentary lifestyle, increased disability and risk of recurrence, resulting in a poorer quality of life (Nindorera et al, 2021;Schmid et al, 2013).Previous studies have shown that motor function, balance, walking capacity and independence in activities of daily living are of importance for perceived health-related QoL (Langhammer et al, 2008(Langhammer et al, , 2014Nindorera et al, 2021).Better quality of life has been reported to be associated with greater independence in daily living and mobility (Heikinheimo & Chimbayo, 2015). Park and Kim (2019) found that gait function is essential for a better QoL in people post stroke.…”

Section: Introductionmentioning

confidence: 99%

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Content and Effectiveness of Community-Based Rehabilitation on Quality of Life in People Post Stroke: a Systematic Review with Meta-Analysis

Noukpo

Kossi

Triccas

et al. 2022

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Purpose:The study aimed to review the content and evaluate the effects of CBR on quality of life (QoL), balance, and walking capacity for people post stroke, compared to other rehabilitation protocols or no care. Methods: A systematic search and meta-analysis of clinical trials of CBR interventions for stroke survivors was conducted. Five online electronic databases (MEDLINE/PubMed, Web of sciences, Scopus, Hinari, and Pedro) were searched for articles published in English and French languages, from inception up to December 2021. Sixteen studies were included that reported on QoL outcomes from CBR interventions involving 1755 adults post stroke. Results: The different CBR interventions that were selected were grouped into three clusters: a) exercise programmes, b) task-oriented training, and c) educational and taking-charge programmes. CBR interventions were more effective than other rehabilitation protocols (SMD=0.16[0.02, 0.30], P=0.03, I 2 =40%) on QoL for people with chronic stroke. The effects of interventions on walking capacity and balance demonstrated non-significant difference 0.64], P=0.06, I 2 =88%, 0.53], P=0.22, I 2 =68%, respectively). Conclusion:Current data indicates that CBR can be used in many forms or in combinations to benefit people with chronic stroke. Also, CBR is as effective as other rehabilitative protocols or no care on walking capacity and balance, while being more while being more effective than institution-based rehabilitation or no care effective than institution-based rehabilitation or no care, in improving quality of life which is a well-recognised goal in the rehabilitation of people with chronic stroke.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Content and Effectiveness of Community-Based Rehabilitation on Quality of Life in People Post Stroke: a Systematic Review with Meta-Analysis

Noukpo

Kossi

Triccas

et al. 2022

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“…The intervention length of the included studies that performed high-dose AT was at least 12 weeks (12-24 weeks), except for one (Ada et al 2003). Nindorera et al (2021) reported that an exercise programme including treadmill and overground walking executed at least three times a week, 30 min per session for 8 weeks of intervention, improves walking performance. Luo et al (2019) reported that a high-intensity exercise programme (70% -85% HRR/VO2 peak, 3-5 times lasting 30-40 minutes per week for 8-12 weeks) was beneficial for walking competency in patients with subacute and chronic stroke.…”

Section: Discussionmentioning

confidence: 99%

Exercise dosage to facilitate the recovery of balance, walking, and quality of life after stroke

Amanzonwe

Triccas

Codjo

et al. 2023

S. Afr. j. physiother.

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Background: Although aerobic training (AT) and resistance training (RT) are recommended after stroke, the optimal dosage of these interventions and their effectiveness on balance, walking capacity, and quality of life (QoL) remain conflicting.Objective: Our study aimed to quantify the effects of different modes, dosages and settings of exercise therapy on balance, walking capacity, and QoL in stroke survivors.Methods: PubMed, CINHAL, and Hinari databases were searched for randomised controlled trials (RCTs) evaluating the effects of AT and RT on balance, walking, and QoL in stroke survivors. The treatment effect was computed by the standard mean differences (SMDs).Results: Twenty-eight trials (n = 1571 participants) were included. Aerobic training and RT interventions were ineffective on balance. Aerobic training interventions were the most effective in improving walking capacity (SMD = 0.37 [0.02, 0.71], p = 0.04). For walking, capacity, a higher dosage (duration ≥ 120 min/week; intensity ≥ 60% heart rate reserve) of AT interventions demonstrated a significantly greater effect (SMD = 0.58 [0.12, 1.04], p = 0.01). Combined AT and RT improved QoL (SMD = 0.56 [0.12, 0.98], p = 0.01). Hospital located rehabilitation setting was effective for improving walking capacity (SMD = 0.57 [0.06, 1.09], p = 0.03) compared with home and/or community and laboratory settings.Conclusions: Our findings showed that neither AT nor RT have a significant effect on balance. However, AT executed in hospital-located settings with a higher dose is a more effective strategy to facilitate walking capacity in chronic stroke. In contrast, combined AT and RT is beneficial for improving QoL.Clinical implications: A high dosage of aerobic exercise, duration ≥ 120 min/week; intensity ≥ 60% heart rate reserve is beneficial for improving walking capacity.

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“…In fact, post-stroke recovery strongly depends on several parameters including the frequency of sessions per week, the intensity (dose) of exercises, the duration of each sessions, the total volume of interventions and also the type of rehabilitation exercise implemented (Corbetta et al 2015 ). In particular, improvement of balance has been shown to be influenced by training intensity, with frequencies of at least five sessions a week of 30–60 min each producing significant improvements within 4 weeks (Nindorera et al 2021 ). Longer-term interventions (e.g.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with balance impairments amongst stroke survivors in northern Benin: A cross-sectional study

Kossi

Agbétou

Noukpo

et al. 2021

South African Journal of Physiotherapy

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Background: Balance impairment is the predominant risk factor for falls in stroke survivors. A fear of falling after stroke can contribute to sedentary lifestyles, increased disability and risk of recurrence, leading to poor quality of life.Objective: To determine the frequency and factors associated with balance impairments amongst stroke survivors at the University Hospital of Parakou.Method: This cross-sectional study included adult stroke survivors. Stroke survivors after discharge were enrolled at the University Hospital of Parakou between 01 January 2020 and 30 September 2020. Balance impairments were measured by using the Berg Balance Scale (BBS), the Timed Up and Go (TUG) and the Get Up and Go (GUG) tests.Results: A total of 54 stroke survivors were included, with a mean age of 58.37 ± 12.42 years and a male predominance of 68.52%. The mean BBS score was 36.87 ± 14.34 with a minimum and a maximum of 10 and 56, respectively. Thirteen (24.07%) had balance impairments (BBS score ≤ 20), 34 (62.96%) had a TUG score ≥ 14 s (abnormal), 9 (16.67%) presented a moderate risk of falling and 6 (11.11%) presented high risk of fall with the GUG test. Post-stroke duration (odds ratio [OR] = 0.04; 95% CI: 0.04–0.30; p 0.01), severity of disability (OR = 8.33; 95% CI: 1.03–67.14; p = 0.03) and the number of physiotherapy sessions (OR = 0.18; 95% CI: 0.03–0.93; p = 0.02) were significantly associated with balance impairments.Conclusion: Our results showed that almost one quarter of stroke survivors after discharge at the University Hospital of Parakou had balance impairments. Post-stroke duration, severity of disability and the number of physiotherapy sessions were significantly associated with balance impairments.Clinical implications: [AQ1] Balance should be regularly assessed in people post-stroke. Further studies should document the content of rehabilitation and any rehabilitative efforts to improve balance in people post-stroke in Benin.

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Effectiveness of walking training on balance, motor functions, activity, participation and quality of life in people with chronic stroke: a systematic review with meta-analysis and meta-regression of recent randomized controlled trials

Cited by 22 publications

References 59 publications

Content and Effectiveness of Community-Based Rehabilitation on Quality of Life in People Post Stroke: a Systematic Review with Meta-Analysis

Content and Effectiveness of Community-Based Rehabilitation on Quality of Life in People Post Stroke: a Systematic Review with Meta-Analysis

Exercise dosage to facilitate the recovery of balance, walking, and quality of life after stroke

Factors associated with balance impairments amongst stroke survivors in northern Benin: A cross-sectional study

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