This is what is so fucking bad about stroke. A review of systematic reviews. This should be totally unnecessary if our fucking failures of stroke associations
would set up a database of stroke research that is updated every time something new is found. Then survivors could go to that database and demand that our doctors and therapists provide those proven interventions. Right now all we have are useless guidelines. Guidelines have no efficacy rating and no defined objective starting point for using them. Everything in stroke rehab is a shot in the dark.
Rehabilitation interventions for improving balance following stroke: An overview of systematic reviews
- Published: July 19, 2019
- https://doi.org/10.1371/journal.pone.0219781
Abstract
Background
The aim of this study was to synthesize evidence from systematic reviews, to summarise the effects of rehabilitation interventions for improving balance in stroke survivors.Methods
We conducted an overview of systematic reviews (SRs). We included Cochrane Systematic Reviews and non-Cochrane Systematic Reviews of randomized-controlled clinical trials and not-randomized clinical trials, in all types of stroke, comparing the effects of interventions, control interventions and no interventions on balance-related outcomes. We conducted a comprehensive search of electronic databases, from inception to December 2017. Data extracted included: number and type of participants, type of intervention, control intervention, method of assessing risk of bias of primary studies, balance outcome measures and results of statistical meta-analyses. Methodological quality of included reviews was assessed using AMSTAR 2. A narrative description of the characteristics of the SRs was provided and results of meta-analyses summarised with reference to their methodological quality.Results
51 SRs (248 primary studies and 10,638 participants) met the inclusion criteria and were included in the overview. All participants were adults with stroke. A wide variety of different balance and postural control outcomes were included. 61% of SRs focussed on the effectiveness of physical therapy, 20% virtual reality, 6% electromechanical devices, 4% Tai-Chi, whole body vibration and circuit training intervention, and 2% cognitive rehabilitation. The methodology of 54% of SRs were judged to be of a “low or critically low” quality, 23% “moderate” quality and 22% “high” quality.Conclusions
There are 51 SRs of evidence relating to the effectiveness of interventions to improve balance in people with stroke, but the majority of these are of poor methodological quality, limiting our ability to draw clear implications. Only 22% of these SRs were judged to be of high quality, highlighting the need to address important methodological issues within rehabilitation research.(So your therapist really has no proven intervention for your balance needs.)
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