The effect of interventions on balance self-efficacy in the stroke population: a systematic review and meta-analysis

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Abstract

Objective:

To conduct a systematic review of clinical trials that examined the effectiveness of interventions on balance self-efficacy among individuals with stroke.

Design:

Systematic review.

Summary of review:

Searches of the following databases were completed in December 2014: MEDLINE (1948-present), CINAHL (1982-present), EMBASE (1980-present) and PsycINFO (1987-present) for controlled clinical trials that measured balance self-efficacy in adults with stroke. Reference lists of selected articles were hand-searched to identify further relevant studies.

Review methods:

Two independent reviewers performed data extraction and assessed the methodological quality of the studies using the Physical Therapy Evidence Database Scale. Standardized mean differences (SMD) were calculated.

Results:

A total of 19 trials involving 729 participants used balance self-efficacy as a secondary outcome. Study quality ranged from poor (n = 3) to good (n = 8). In the meta-analysis of 15 trials that used intensive physical activity interventions, a moderate beneficial effect on balance self-efficacy was observed immediately following the programs (SMD 0.44, 95% CI 0.11–0.77, P = 0.009). In the studies that included follow-up assessments, there was no difference between groups across retention periods (eight studies, SMD 0.32, 95% CI -0.17–0.80, P = 0.20). In the four studies that used motor imagery interventions, there was no between-group difference in change in balance self-efficacy (fixed effects SMD 0.68, 95% CI -0.33–1.69, P = 0.18).

Conclusions:

Physical activity interventions appear to be effective in improving balance self-efficacy after stroke.

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