Effect of Traditional Chinese Exercise on Gait and Balance for Stroke: A Systematic Review and Meta-Analysis.
OBJECTIVE
A systematic review is conducted to determine the effect of traditional Chinese exercise for patients with stroke.


METHODS
Studies are obtained from PubMed, Embase, Cochrane Library, EBSCO, Web of Science, and CNKI. Only randomized controlled trials were left to evaluate the effects of traditional Chinese exercise for patients with stroke, and with no limits on study data or language. The primary outcome was the Berg balance score (BBS), Functional walking scale. And a random-effects model was used to calculate the pooled mean difference (MD) with 95% confidence interval (CI).


RESULTS
A total of 9 studies on 820 participants conform to the inclusion criteria, whereas eight studies on 704 participants are used as data sources for the meta-analysis, all trials were published between 2004 and 2013. The BBS indicates that the efficacy of traditional Chinese exercise on balance of patients with stroke is better than that of other training or no training in short term [MD (95%CI) = 11.85 [5.41, 18.30], P < 0.00001]. And the short physical performance battery, Functional walking scale, limit of stability were observed significant differences on balance (p<0.05) and gait (p<0.05) between traditional Chinese exercise and other exercises or no exercise. In addition, there is an article showed that some other form (physiotherapy exercises focused on balance) significantly improved balance ability for stroke patients compared to tai chi chuan practice (Berg test = 0.01, Romberg, and standing on one leg).


CONCLUSIONS
In our meta analysis, the positive findings of this study suggest traditional Chinese exercise has beneficial effects on the balance ability in short term. However, we drew the conclusion according to the extreme heterogeneity, and evidence of better quality and from a larger sample size is required. Because of the inconsistent outcomes, there are short of enough good evidence for patients with stroke to prove the effects of traditional Chinese exercise on gait.


BACKGROUND
http://www.crd.york.ac.uk/PROSPERO PROSPERO registration number: CRD42013006474.
Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.
Bing-Lin
BL
Chen
Second School of Clinical Medical, Nanjing University of Chinese Medicine, Nanjing, China.
Jia-Bao
JB
Guo
Bulloch Academy, Statesboro, United States of America.
Ming-Shuo
MS
Liu
Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.
Xin
X
Li
Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China.
Jun
J
Zou
Kinesiology and Exercise Science, Shanghai University of Sport, Shanghai, China.
Xi
X
Chen
Kinesiology and Exercise Science, Shanghai University of Sport, Shanghai, China.
Ling-Li
LL
Zhang
Second School of Clinical Medical, Nanjing University of Chinese Medicine, Nanjing, China.
Yu-Shan
YS
Yue
Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China; Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China.
Xue-Qiang
XQ
Wang
D000368:Aged; D005081:Exercise Therapy / Q000379:methods; D005684:Gait; D006801:Humans; D008516:Medicine, Chinese Traditional / Q000379:methods; D004856:Postural Balance; D020521:Stroke / Q000628:therapy*; D026302:Tai Ji