- •Noninvasive brain stimulation improved deficits in functional balance and postural control poststroke.
- •The treatment effects on postural imbalance were significant following repetitive transcranial magnetic stimulation (rTMS).
- •The improvements after rTMS appeared in patients with history of acute, subacute, and chronic stroke.
- •A higher number of rTMS sessions significantly increased the treatment effects.
The postural imbalance poststroke limits individuals’ walking abilities as well as increase the risk of falling. We investigated the short-term treatment effects of noninvasive brain stimulation (NIBS) on functional balance and postural control in patients with stroke.
We started the search via PubMed and the Institute for Scientific Information’s Web of Science on March 1, 2019 and concluded the search on April 30, 2019.
The meta-analysis included studies that used either repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) for the recovery of functional balance and postural control poststroke. All included studies used either randomized controlled trial or crossover designs with a sham control group.
Three researchers independently performed data extraction and assessing methodological quality and publication bias. We calculated overall and individual effect sizes using random effects meta-analysis models.
The random effects meta-analysis model on the 18 qualified studies identified the significant positive effects relating to NIBS in terms of functional balance and postural control poststroke. The moderator-variable analyses revealed that these treatment effects were only significant in rTMS across patients with acute, subacute, and chronic stroke whereas tDCS did not show any significant therapeutic effects. The meta-regression analysis showed that a higher number of rTMS sessions was significantly associated with more improvements in functional balance and postural control poststroke.
Our systematic review and meta-analysis confirmed that NIBS may be an effective option for restoring functional balance and postural control for patients with stroke.
List of abbreviations:CI (confidence interval), M1 (primary motor cortex), NIBS (noninvasive brain stimulation), PEDro (the Physiotherapy Evidence Database), rTMS (repetitive transcranial magnetic stimulation), SMA (supplementary motor area), SMD (standardized mean difference), tDCS (transcranial direct current stimulation)
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Published online: September 27, 2019
Supported by Incheon National University, South Korea (grant no. 2017-0389).
© 2019 by the American Congress of Rehabilitation Medicine