title: The effect of interventions on balance self-efficacy in the stroke population: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To conduct a systematic review of clinical trials that examined the effectiveness of interventions on balance self-efficacy among individuals with stroke.
  
  
  METHODS
  Systematic review.
  
  
  RESULTS
  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.
  
  
  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.
authors: McMaster University School of Rehabilitation Science Population Health Research Institute, Hamilton, Canada Canadian Partnership for Stroke Recovery, Ottawa, Canada atang@mcmaster.ca.
authors: Ada
authors: A
authors: Tang
authors: Department of Physical Therapy, University of British Columbia, Faculty of Medicine, Vancouver, Canada.
authors: Amy
authors: A
authors: Tao
authors: Department of Physical Therapy, University of British Columbia, Faculty of Medicine, Vancouver, Canada.
authors: Michelle
authors: M
authors: Soh
authors: Department of Physical Therapy, University of British Columbia, Faculty of Medicine, Vancouver, Canada.
authors: Carolyn
authors: C
authors: Tam
authors: Department of Physical Therapy, University of British Columbia, Faculty of Medicine, Vancouver, Canada.
authors: Hannah
authors: H
authors: Tan
authors: Department of Physical Therapy, University of British Columbia, Faculty of Medicine, Vancouver, Canada.
authors: Jessica
authors: J
authors: Thompson
authors: Canadian Partnership for Stroke Recovery, Ottawa, Canada Department of Physical Therapy, University of British Columbia, Faculty of Medicine, Vancouver, Canada Vancouver Coastal Health, Vancouver, Canada International Collaboration on Repair Discoveries, Vancouver, Canada.
authors: Janice J
authors: JJ
authors: Eng
mesh_terms: D006801:Humans; D004856:Postural Balance; D020377:Self Efficacy; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation
keywords: Stroke; balance; meta-analysis; self-efficacy; systematic review