Department of Physiotherapy, 16781University of Valencia, Valencia, Spain.
Area of Physiotherapy, Hospital Vall d'Hebron, Barcelona, Spain.
Clin Rehabil. 2022 Dec;36(12):1635-1654. doi: 10.1177/02692155221117220. Epub 2022 Jul 26.
The aim of this systematic review and meta-analysis of randomised controlled trials (RCTs) includes determining the effects of core training alone or combined with conventional therapy on trunk function, balance, and gait in stroke patients; analysing these effects considering the stroke stage and the core training type; establishing the methodological quality of the studies published to date; and knowing the best dosage and type of exercise these aspects.
Cochrane Library, Medline, Web of Science, Scopus, and Science Direct were searched from inception to January 2022.
A review and meta-analysis of RCTs about core intervention effects on trunk function, balance, and gait in stroke patients was carried out following the Preferred Items for Reporting in Systematic Review and Meta-Analyses guidelines. The Cochrane Collaboration tool was used to assess the risk of bias and internal validity of the included studies.
Twenty-nine studies were included (1030 stroke patients). The mean age of the participants was 58.46 ± 9.89 years, and the average time since the stroke incident was 308.64 ± 175.52 days. The meta-analysis results showed significant improvements in core interventions for trunk function ( ≤ 0.008) and balance ( < 0.00001) but not for gait performance ( = 0.11 in chronic and = 0.06 in pooled cases). In relation to the differential meta-analysis between training performed on stable and unstable surfaces, no significant differences were found in trunk function ( = 0.06) or balance measures ( = 0.05).
Core training improves trunk function and balance in acute and chronic patients, but no changes were found in gait performance.
本系统评价和随机对照试验(RCT)的荟萃分析旨在确定核心训练单独或与常规治疗相结合对脑卒中患者躯干功能、平衡和步态的影响;分析考虑脑卒中阶段和核心训练类型的这些影响;评估迄今为止发表的研究的方法学质量;并了解这些方面的最佳运动剂量和类型。
从创建到 2022 年 1 月,在 Cochrane 图书馆、Medline、Web of Science、Scopus 和 Science Direct 上进行了搜索。
根据系统评价和荟萃分析的首选报告项目指南,对关于核心干预对脑卒中患者躯干功能、平衡和步态影响的 RCT 进行了综述和荟萃分析。使用 Cochrane 协作工具评估纳入研究的偏倚风险和内部有效性。
共纳入 29 项研究(1030 例脑卒中患者)。参与者的平均年龄为 58.46 ± 9.89 岁,脑卒中后平均时间为 308.64 ± 175.52 天。荟萃分析结果表明,核心干预对躯干功能( ≤ 0.008)和平衡( < 0.00001)有显著改善,但对步态表现没有改善( = 0.11 为慢性期, = 0.06 为汇总病例)。关于在稳定和不稳定表面上进行的训练的差异荟萃分析,在躯干功能( = 0.06)或平衡测量方面未发现显著差异( = 0.05)。
核心训练可改善急性和慢性脑卒中患者的躯干功能和平衡,但对步态表现无变化。