The effect of balance training on balance performance in individuals poststroke

A systematic review

Anat Lubetzky, Deborah Kartin

Research output: Contribution to journalReview article

Abstract

Background and Purpose: Stroke is a leading cause of long-term disability, and impaired balance after stroke is strongly associated with future function and recovery. Until recently there has been limited evidence to support the use of balance training to improve balance performance in this population. Information about the optimum exercise dosage has also been lacking. This review evaluated recent evidence related to the effect of balance training on balance performance among individuals poststroke across the continuum of recovery. On the basis of this evidence, we also provide recommendations for exercise prescription in such programs. Methods: A systematic search was performed on literature published between January 2006 and February 2010, using multiple combinations of intervention (eg, "exercise"), population (eg, "stroke"), and outcome (eg, "balance"). Criteria for inclusion of a study was having at least 1 standing balance exercise in the intervention and 1 study outcome to evaluate balance. Results: Twenty-two published studies met the inclusion criteria. We found moderate evidence that balance performance can be improved following individual, "one-on-one" balance training for participants in the acute stage of stroke, and either one-on-one balance training or group therapy for participants with subacute or chronic stroke. Moderate evidence also suggests that in the acute stage, intensive balance training for 2 to 3 times per week may be sufficient, whereas exercising for 90 minutes or more per day, 5 times per week may be excessive. Discussion and Conclusions: This review supports the use of balance training exercises to improve balance performance for individuals with moderately severe stroke. Future high-quality, controlled studies should investigate the effects of balance training for individuals poststroke who have severe impairment, additional complications/comorbidities, or specific balance lesions (eg, cerebellar or vestibular). Optimal training dosage should also be further explored. Studies with long-term follow-up are needed to assess outcomes related to participation in the community and reduction of fall risk.

Original languageEnglish (US)
Pages (from-to)127-137
Number of pages11
JournalJournal of Neurologic Physical Therapy
Volume34
Issue number3
DOIs
StatePublished - Sep 2010

Fingerprint

Stroke
Recovery of Function
Risk Reduction Behavior
Group Psychotherapy
Population
Prescriptions
Comorbidity
Outcome Assessment (Health Care)
Exercise

Keywords

  • balance
  • exercise
  • stroke
  • systematic review
  • training

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology

Cite this

The effect of balance training on balance performance in individuals poststroke : A systematic review. / Lubetzky, Anat; Kartin, Deborah.

In: Journal of Neurologic Physical Therapy, Vol. 34, No. 3, 09.2010, p. 127-137.

Research output: Contribution to journalReview article

@article{ad19cdebb6e24c3b8c73270e67c5d0d0,
title = "The effect of balance training on balance performance in individuals poststroke: A systematic review",
abstract = "Background and Purpose: Stroke is a leading cause of long-term disability, and impaired balance after stroke is strongly associated with future function and recovery. Until recently there has been limited evidence to support the use of balance training to improve balance performance in this population. Information about the optimum exercise dosage has also been lacking. This review evaluated recent evidence related to the effect of balance training on balance performance among individuals poststroke across the continuum of recovery. On the basis of this evidence, we also provide recommendations for exercise prescription in such programs. Methods: A systematic search was performed on literature published between January 2006 and February 2010, using multiple combinations of intervention (eg, {"}exercise{"}), population (eg, {"}stroke{"}), and outcome (eg, {"}balance{"}). Criteria for inclusion of a study was having at least 1 standing balance exercise in the intervention and 1 study outcome to evaluate balance. Results: Twenty-two published studies met the inclusion criteria. We found moderate evidence that balance performance can be improved following individual, {"}one-on-one{"} balance training for participants in the acute stage of stroke, and either one-on-one balance training or group therapy for participants with subacute or chronic stroke. Moderate evidence also suggests that in the acute stage, intensive balance training for 2 to 3 times per week may be sufficient, whereas exercising for 90 minutes or more per day, 5 times per week may be excessive. Discussion and Conclusions: This review supports the use of balance training exercises to improve balance performance for individuals with moderately severe stroke. Future high-quality, controlled studies should investigate the effects of balance training for individuals poststroke who have severe impairment, additional complications/comorbidities, or specific balance lesions (eg, cerebellar or vestibular). Optimal training dosage should also be further explored. Studies with long-term follow-up are needed to assess outcomes related to participation in the community and reduction of fall risk.",
keywords = "balance, exercise, stroke, systematic review, training",
author = "Anat Lubetzky and Deborah Kartin",
year = "2010",
month = "9",
doi = "10.1097/NPT.0b013e3181ef764d",
language = "English (US)",
volume = "34",
pages = "127--137",
journal = "Journal of Neurologic Physical Therapy",
issn = "1557-0576",
publisher = "American Physical Therapy Association",
number = "3",

}

TY - JOUR

T1 - The effect of balance training on balance performance in individuals poststroke

T2 - A systematic review

AU - Lubetzky, Anat

AU - Kartin, Deborah

PY - 2010/9

Y1 - 2010/9

N2 - Background and Purpose: Stroke is a leading cause of long-term disability, and impaired balance after stroke is strongly associated with future function and recovery. Until recently there has been limited evidence to support the use of balance training to improve balance performance in this population. Information about the optimum exercise dosage has also been lacking. This review evaluated recent evidence related to the effect of balance training on balance performance among individuals poststroke across the continuum of recovery. On the basis of this evidence, we also provide recommendations for exercise prescription in such programs. Methods: A systematic search was performed on literature published between January 2006 and February 2010, using multiple combinations of intervention (eg, "exercise"), population (eg, "stroke"), and outcome (eg, "balance"). Criteria for inclusion of a study was having at least 1 standing balance exercise in the intervention and 1 study outcome to evaluate balance. Results: Twenty-two published studies met the inclusion criteria. We found moderate evidence that balance performance can be improved following individual, "one-on-one" balance training for participants in the acute stage of stroke, and either one-on-one balance training or group therapy for participants with subacute or chronic stroke. Moderate evidence also suggests that in the acute stage, intensive balance training for 2 to 3 times per week may be sufficient, whereas exercising for 90 minutes or more per day, 5 times per week may be excessive. Discussion and Conclusions: This review supports the use of balance training exercises to improve balance performance for individuals with moderately severe stroke. Future high-quality, controlled studies should investigate the effects of balance training for individuals poststroke who have severe impairment, additional complications/comorbidities, or specific balance lesions (eg, cerebellar or vestibular). Optimal training dosage should also be further explored. Studies with long-term follow-up are needed to assess outcomes related to participation in the community and reduction of fall risk.

AB - Background and Purpose: Stroke is a leading cause of long-term disability, and impaired balance after stroke is strongly associated with future function and recovery. Until recently there has been limited evidence to support the use of balance training to improve balance performance in this population. Information about the optimum exercise dosage has also been lacking. This review evaluated recent evidence related to the effect of balance training on balance performance among individuals poststroke across the continuum of recovery. On the basis of this evidence, we also provide recommendations for exercise prescription in such programs. Methods: A systematic search was performed on literature published between January 2006 and February 2010, using multiple combinations of intervention (eg, "exercise"), population (eg, "stroke"), and outcome (eg, "balance"). Criteria for inclusion of a study was having at least 1 standing balance exercise in the intervention and 1 study outcome to evaluate balance. Results: Twenty-two published studies met the inclusion criteria. We found moderate evidence that balance performance can be improved following individual, "one-on-one" balance training for participants in the acute stage of stroke, and either one-on-one balance training or group therapy for participants with subacute or chronic stroke. Moderate evidence also suggests that in the acute stage, intensive balance training for 2 to 3 times per week may be sufficient, whereas exercising for 90 minutes or more per day, 5 times per week may be excessive. Discussion and Conclusions: This review supports the use of balance training exercises to improve balance performance for individuals with moderately severe stroke. Future high-quality, controlled studies should investigate the effects of balance training for individuals poststroke who have severe impairment, additional complications/comorbidities, or specific balance lesions (eg, cerebellar or vestibular). Optimal training dosage should also be further explored. Studies with long-term follow-up are needed to assess outcomes related to participation in the community and reduction of fall risk.

KW - balance

KW - exercise

KW - stroke

KW - systematic review

KW - training

UR - http://www.scopus.com/inward/record.url?scp=77956043184&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77956043184&partnerID=8YFLogxK

U2 - 10.1097/NPT.0b013e3181ef764d

DO - 10.1097/NPT.0b013e3181ef764d

M3 - Review article

VL - 34

SP - 127

EP - 137

JO - Journal of Neurologic Physical Therapy

JF - Journal of Neurologic Physical Therapy

SN - 1557-0576

IS - 3

ER -