Proprioceptive training as a strategy to improve balance in individuals’ post-stroke: a systematic review
DOI:
https://doi.org/10.25758/set.770Keywords:
Stroke, Balance, Proprioceptive training, Postural control, Postural stability, PhysiotherapyAbstract
Introduction – Balance disorders are responsible for more than half of all stroke consequences. That is why it is still very important to investigate the best intervention strategy for this kind of disorder according to the most recent evidence. Although proprioceptive training is considered a valid type of training in post-stroke individuals, its contribution to improving balance remains to be clarified. Aim – To verify the effectiveness of proprioceptive training to improve balance in post-stroke individuals. Methods – A systematic review was carried out, based on the methodology defined in PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). The databases used were PubMed, PEDro, and ScienceDirect. The methodological quality of the studies was assessed using the PEDro Scale. Inclusion criteria: randomized controlled studies (RCT) in individuals 18 years of age or older, diagnosed with stroke with balance impairments, whose intervention includes proprioceptive training and assessment containing objective measures of balance. Exclusion criteria: studies in individuals with other neurological morbidities, musculoskeletal pathology in the lower limbs, or other types of pathologies likely to influence the proprioceptive system. Results – The database search identified 855 studies, 14 of which were included in this review, according to eligibility criteria. These involved 677 individuals diagnosed with stroke, chronic (seven studies) and acute/subacute (seven studies). The types of proprioceptive training used in the intervention groups (IG) consisted of: balance; somatosensory stimulation with vibration or functional electrical stimulation; and joint repositioning, combined with conventional physiotherapy, also applied in the control groups (CG). The objective balance assessment used consisted of Berg (BBS) and/or Tinneti (TBS) balance scales and the Mini-Balance Evaluation Systems Test (Mini-Best). There were statistically significant differences (p<0.05) between IG and CG in 10 out of 14 studies. Conclusion – According to this review, despite the differences between the interventions (like the type and duration of exercises) and the scales used to measure the results, there is a tendency, for most of the included studies, to show improvements in the results of balance and proprioceptive training measures.
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