The effects of different exercise modes on walking ability and balance function in chronic stroke survivors: A systematic review and network meta-analysis of randomized controlled trials

Background: Walking and balance problems are the main concerns for chronic stroke survivors, and the most effective exercise modalities for enhancing them remain unknown. Objective: As the main indicators for detecting walking ability and balance function, the effect of different exercise modes on 10-meter walking test (10MWT), 6-min walking test (6MWT), Berg Balance Scale (BBS), and timed up-and-go test (TUGT) were investigated and analyzed. Methods: A literature search was conducted in PubMed, EMBASE, and Cochrane Library databases, and only randomized controlled trials (RCTs) were included. 'Cochrane assessment tool' was used to assess the risk of bias. Statistical analysis was performed using Stata, presenting network, surface under the cumulative ranking curve (SUCRA), and publication bias graphs. Results: A total of 36 RCTs involving 1466 participants were included in this network meta-analysis. The results of data analysis showed that the traditional Chinese exercise (TCE) could effectively reduce 10MWT (SUCRA = 80.9%) and TUGT (SUCRA = 73.7%) scores. Additionally, walking could significantly increase 6MWT (SUCRA = 82.2%) and BBS scores (SUCRA = 89.9%). Conclusion: All types of exercises improve walking ability and balance function to some degree, particularly walking exercises for 6MWT and BBS.