Effects of cardiorespiratory physiotherapy on balance and gait in stroke: a network meta-analysis of randomised controlled trials.

Abstract

To investigate effects of various cardiorespiratory physiotherapy interventions on balance and gait in patients with stroke. This systematic review and network meta-analysis searched PubMed, EMBASE, Cochrane Library, and Web of Science for articles from 2000 to 2023. Twenty-nine RCTs on stroke patients were selected, involving interventions like ground-based aerobic training (GBAT), resistance training (RT), aquatic training (AT), robot-assisted training (RAT), inspiratory training (IT), combined aerobic and resistance training (CART), and combined aerobic and breathing training (CABT). Outcome variables were Berg Balance Scale (BBS), 6-minute walk test (6MWT), and 10-meter walk test (10MWT) scores. The analysis included 29 articles with 1,370 participants. On the BBS, RT was the most effective (99.66%), significantly more than conventional training (CT) (mean, 95% CI: 1.538, 0.771-2.304). For the 6MWT, CABT ranked highest (85.39%), with all interventions except AT showing significant effects compared to no intervention (N). For the 10MWT, GBAT ranked highest (81.71%), with significant effects for N versus GBAT (0.744, 0.308-1.180) and CART (0.732, 0.257-1.207). Comparisons of CT versus CART and N versus IT in the 6MWT had moderate evidence quality. The findings emphasise the importance of incorporating aerobic, strength, and respiratory exercises alongside conventional physical therapy for optimal outcomes. CRD42023387282.