Effects of exercise on mobility, balance and gait in patients with the chronic stroke: a systematic review and meta-analysis

The aim of this research was to evaluate the effects of exercise training on mobility, balance and gait parameters, with a particular emphasis on the timed up and go test (TUG), the Berg Balance Scale (BBS), the 6-minute walk test (6MWT), and the 10-meter walk test (10MWT). A systematic search was conducted across several databases, namely Web of Science, Embase, PubMed, and the Cochrane Library for randomized controlled trials (RCTs), to evaluate the effects of exercise interventions on mobility, balance and gait in chronic stroke patients. After rigorous screening, 13 RCTs with both experimental and control groups (193/190 participants) were found eligible for inclusion. The meta-analysis demonstrated significant improvement in the mobility ability, as measured by TUG test after exercise intervention (MD = - 4.81, p < 0.01, 95% CI [- 8.23 to - 1.38]). Furthermore, exercise effectively enhanced the balance ability, as measured by the BBS, among chronic stroke patients (MD = 3.81, p < 0.01, 95% CI [1.98-5.64]). However, no statistically significant impact of exercise training was observed on the 6MWT (SMD = 0.00, p > 0.05, 95% CI [- 0.24 to 0.25]) or 10MWT (SMD = 0.03, p > 0.05, 95% CI [- 0.07 to 0.12]). Exercise training interventions significantly increased mobility and balance scores in chronic stroke patients. However, they had no effect on gait scores. The results of further subgroup analysis show that aerobic training (AT) has a significant effect in enhancing the activity ability index of patients, while resistance training (RT) shows an obvious advantage in improving the balance index evaluated by the Berg Balance Scale (BBS).