AUTHOR=Jiang Zhaoxiang , Zhang Xinxin , Fu Qian , Tao Yimin 

TITLE=Effects of body weight support training on balance and walking function in stroke patients: a systematic review and meta-analysis

JOURNAL=Frontiers in Neurology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1413577

DOI=10.3389/fneur.2024.1413577

ISSN=1664-2295

ABSTRACT=<sec id="sec1"><title>Objective</title><p>To comprehensively and quantitatively evaluate the impact of body weight support training (BWST) on balance and gait function in stroke patients based on an evidence-based basis and to identify the most effective intervention strategies.</p></sec><sec id="sec2"><title>Methods</title><p>PubMed, Web of Science, The Cochrane Library, CNKI, Wanfang, and Chinese SinoMed Database were searched until November 25, 2023. Quality assessment and meta-analysis were performed using RevMan 5.2 and Stata 14.0 software.</p></sec><sec id="sec3"><title>Results</title><p>A total of 31 randomized controlled trials involving 1,918 patients were included in the study. The meta-analysis demonstrated that body weight support training (BWST) significantly improved Berg Balance Scale (BBS) scores (MD = 3.60; 95% CI: 1.23 to 5.98; <italic>p</italic> = 0.003), gait speed (SMD = 0.77; 95% CI: 0.38 to 1.15; <italic>p</italic> &lt; 0.0001), and step length (SMD = 0.46; 95% CI: 0.19 to 0.72; <italic>p</italic> = 0.0008) in stroke patients compared to conventional rehabilitation. For enhancing balance function, the most effective interventions were identified as a disease duration of 3–6 months (MD = 5.16; 95% CI: 0.76 to 9.57; <italic>p</italic> = 0.02), intervention time of 4–8 weeks (MD = 5.70; 95% CI: 2.90 to 8.50; <italic>p</italic> &lt; 0.0001), a maximum body weight support level above 30% (MD = 3.80; 95% CI: 1.48 to 6.13; <italic>p</italic> = 0.001), and a maximum training walking speed of 0.2 m/s or more (MD = 4.66; 95% CI: 0.37 to 9.70; <italic>p</italic> = 0.03). For improving walking function, the optimal interventions were also a disease duration of 3–6 months (gait speed: SMD = 0.59; 95% CI: 0.15 to 1.03; <italic>p</italic> = 0.008; step length: SMD = 0.27; 95% CI: 0.06 to 0.56; <italic>p</italic> = 0.04), intervention time of 4–8 weeks (gait speed: SMD = 1.01; 95% CI: 0.44 to 1.59; <italic>p</italic> = 0.0006; step length: SMD = 0.83; 95% CI: 0.54 to 1.12; <italic>p</italic> &lt; 0.00001), a maximum body weight support level above 30% (gait speed: SMD = 0.79; 95% CI: 0.36 to 1.22; <italic>p</italic> = 0.0003; step length: SMD = 0.79; 95% CI: 0.47 to 1.11; <italic>p</italic> &lt; 0.00001), and a maximum training walking speed of 0.2 m/s or more (gait speed: SMD = 1.26; 95% CI: 0.62 to 1.90; <italic>p</italic> = 0.0001; step length: SMD = 0.85; 95% CI: 0.38 to 1.31; <italic>p</italic> = 0.0003).</p></sec><sec id="sec4"><title>Conclusion</title><p>Compared with conventional rehabilitation training, BWST demonstrates superior efficacy in enhancing balance and walking function in stroke patients, with a consistent optimal intervention strategy. The most effective program includes a disease duration of 3–6 months, an intervention period of 4–8 weeks, a maximum body weight support of 30% or more, and a maximum training walking speed of 0.2 m/s or greater.</p></sec><sec id="sec5"><title>Systematic review registration</title><p><ext-link xlink:href="http://www.crd.york.ac.uk/PROSPERO/" ext-link-type="uri" xmlns:xlink="http://www.w3.org/1999/xlink">http://www.crd.york.ac.uk/PROSPERO/</ext-link>, identifier: CRD42022358963.</p></sec>