The Effect of Multimodal Therapy on Balance Outcomes ofStroke Survivors: A Systematic Review

Abstract

Background and objective: Stroke often lead to motor impairments and balance disorders in affected individuals. The improvement of balance control is of utmost importance in stroke treatment, and recent research suggests that combining specialized techniques may offer promising results in enhancing balance outcomes. However, the optimal combination of therapies for achieving the best outcomes remains unclear. Therefore, this study aims to examine the effect of combining two or more therapy approaches on balance control among patients with stroke by conducting a comprehensive systematic review. Methods: A systematic search was conducted across six electronic databases (PubMed, Scopus, EBSCOHost, Web of Sciences, OVID Medline, and Wiley) until October 2020 to find pertinent studies. The inclusion criteria involved clinical trials that compared combined specialized approaches with conventional rehabilitation exercise to conventional exercise alone, with reported balance outcomes, conducted in humans, and published in English. The methodological quality of the chosen articles was evaluated using the PEDro scale. Results: This study reviewed eleven high-quality studies, published between 2015 and 2019, with PEDro scores ranging from six to eight out of 11. These scores indicated that the included studies can be categorized as high-quality evidences. The findings from the majority of these studies indicated that combining conventional exercise with task-oriented exercise, water-based therapy, mirror therapy, electrical stimulation, or proprioceptive neuromuscular facilitation resulted in significant improvements in postural balance when compared to the control group after the intervention. Conclusions: Multimodal therapy techniques have demonstrated favorable outcomes in improving balance performance among patients with stroke, emphasizing the importance of personalized combinations and dosages for effective rehabilitation.