Ballistic Resistance Training: Feasibility, Safety, and Effectiveness for Improving Mobility in Adults With Neurologic Conditions: A Systematic Review

Objectives: To determine whether ballistic resistance training is feasible, safe, and effective in improving muscle strength, power generation, and mobility in adults with neurologic conditions. Data Sources: Nine electronic databases were searched from inception to March 2019 in addition to the reference lists of included articles. Study Selection: Articles were independently screened by 2 authors and were included if they were full-text; English-language articles published in a peer-reviewed journal; investigated ballistic resistance training for adults with a neurologic condition; and reported on feasibility, safety, strength, power, or mobility. Data Extraction: Two authors independently extracted data. Study quality was assessed using the McMaster critical review form and the Physiotherapy Evidence Database scale. Data Synthesis: The search identified 1540 articles, with 13 articles describing 9 studies meeting the criteria for inclusion. Five studies were randomized controlled trials and 4 were cohort studies. Ballistic resistance training was feasible and safe with only 1 intervention-related adverse event reported. Findings indicated improvements in strength for hip abduction, leg press, knee flexion, and ankle dorsiflexion, but not for hip flexion, hip extension, knee extension, or ankle plantarflexion. Muscle power generation improved for hip flexion, hip abduction, leg press, knee extension, and knee flexion, but not for ankle plantarflexion. Treatment effect was positive for self-selected walking speed, with a standardized mean difference (SMD) of 0.69 (95% confidence interval [CI], 0.01-1.38) from 3 studies. However, fastest comfortable walking speed results were inconclusive with a SMD from 4 studies of 0.45 (95% CI, -0.01 to 0.91). Conclusions: Ballistic training is safe and feasible for people with a neurologic condition. The effects on muscle strength, power generation, and mobility were found to be positive but not conclusive. (C) 2020 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine