Li Xiaofang, Wu Chengcheng, Zhang Jiayu, Zeng Qunmei, Wang Yinhua
Guiyang Maternal and Child Health Care Hospital, Guiyang, China.
Faculty of Nursing, Guizhou Medical University, Guiyang, China.
Worldviews Evid Based Nurs. 2025 Aug;22(4):e70057. doi: 10.1111/wvn.70057.
Home-based exercise offers a cost-effective way to receive thorough rehabilitation without the requirement of costly supervised treatment.
To investigate the effects of home-based exercise on the balance ability in post-stroke patients.
A thorough search was carried out on various databases, such as Cochrane Library, Web of Science, PubMed, Embase, and China National Knowledge Infrastructure Library, until October 2024. The inclusion criteria were limited to randomized controlled trials that evaluated the impact of home-based exercise interventions.
The meta-analysis indicated that home-based exercise significantly improved static balance ability (Berg Balance Scale [BBS]: MD = 3.45, 95% CI [1.43, 5.47], I = 71%, p = 0.0008, random-effects model). Conversely, the analysis revealed that the home-based exercise group did not exhibit a statistically significant improvement in the Time up and Go Test (TUG) when compared to the control group (TUG: MD = -0.34, 95% CI [-4.30, 3.61], I = 96%, p = 0.86, random effects model). The subgroup analysis revealed that home-based exercise significantly enhanced balance ability in patients with subacute stroke (BBS: p < 0.0001; TUG: Overall effect p = 0.02). However, no significant improvement was observed in patients with chronic stroke (BBS: p = 0.39). Regarding the duration of intervention, both short-term and long-term interventions were effective on the BBS (p < 0.0001 and p = 0.0008, respectively), although no significant difference was found for the TUG. Participants engaging in exercise for more than 90 min per week demonstrated greater improvements in balance ability (BBS: p < 0.0001; TUG: p = 0.02). When considering national economic levels, significant effects on the BBS were observed in both developed and developing countries (p = 0.0001 and p < 0.0001, respectively), while significant effects on the TUG were noted only in developing countries (p = 0.04).
Home-based exercise interventions showed significant results in improving static balance in patients with subacute stroke, especially home-based exercise that lasted longer than 12 weeks and lasted at least 90 min per week. However, more methodologically rigorous randomized controlled trials are needed to validate these results. In addition, the optimal exercise program and type to optimize the balance ability of stroke patients also need further research.
家庭锻炼提供了一种经济有效的方式来接受全面康复，而无需昂贵的监督治疗。
探讨家庭锻炼对中风后患者平衡能力的影响。
截至2024年10月，对多个数据库进行了全面检索，如考克兰图书馆、科学网、PubMed、Embase和中国知网。纳入标准仅限于评估家庭锻炼干预影响的随机对照试验。
荟萃分析表明，家庭锻炼显著改善了静态平衡能力（伯格平衡量表[BBS]：MD = 3.45，95%可信区间[1.43，5.47]，I = 71%，p = 0.0008，随机效应模型）。相反，分析显示，与对照组相比，家庭锻炼组在起立行走测试（TUG）中未表现出统计学上的显著改善（TUG：MD = -0.34，95%可信区间[-4.30，3.61]，I = 96%，p = 0.86，随机效应模型）。亚组分析显示，家庭锻炼显著提高了亚急性中风患者的平衡能力（BBS：p < 0.0001；TUG：总体效应p = 0.02）。然而，慢性中风患者未观察到显著改善（BBS：p = 0.39）。关于干预持续时间，短期和长期干预对BBS均有效（分别为p < 0.0001和p = 0.0008），尽管TUG未发现显著差异。每周锻炼超过90分钟的参与者在平衡能力方面有更大改善（BBS：p < 0.0001；TUG：p = 0.02）。考虑到国家经济水平，发达国家和发展中国家对BBS均有显著影响（分别为p = 0.0001和p < 0.0001），而对TUG的显著影响仅在发展中国家观察到（p = 0.04）。
家庭锻炼干预在改善亚急性中风患者的静态平衡方面显示出显著效果，特别是持续时间超过12周且每周至少持续90分钟的家庭锻炼。然而，需要更多方法学严谨的随机对照试验来验证这些结果。此外，优化中风患者平衡能力的最佳锻炼方案和类型也需要进一步研究。
