Background:
Patients with post stroke hemiparesis have poor postural stability;
nevertheless, it is unclear whether vestibular rehabilitation affects
gait performance after a stroke or not. We performed a systematic review
of randomized controlled trials to investigate the effects of
vestibular rehabilitation on gait performance in patients with post
stroke.
Methods:
The Medline, Cochrane Central Register of
Controlled Trials, Physiotherapy Evidence Database, and Cumulative Index
to Nursing and Allied Health Literature databases were comprehensively
searched. All literature published from each source's earliest date to
June 2019 was included. Study selection and data extraction were
performed independently by paired reviewers. Outcomes of gait
performance were the 10-Meter Walking Test, Timed Up and Go Test, and
Dynamic Gait Index. We applied the Physiotherapy Evidence Database scale
to evaluate the risk of bias and the Grading of Recommendations
Assessment, Development and Evaluation system to evaluate the quality of
a body of evidence.
Results:
Three studies were included, and
two out of three trials showed beneficial effects of vestibular
rehabilitation in post-stroke patients. Quality assessment using the
Grading of Recommendations Assessment, Development and Evaluation
criteria found very low-quality evidence of all included studies due to
inadequate allocation concealment, low participant numbers, and lack of
blinding.
Conclusion:
This review found beneficial effects of
vestibular rehabilitation on gait performance in patients with stroke.
However, due to the very low-quality evidence of previous randomized
controlled trials as assessed by the Grading of Recommendations
Assessment, Development and Evaluation criteria, definitive conclusions
on the effectiveness of vestibular rehabilitation cannot be made. Hence,
more high-quality and large-scale randomized controlled trials of
vestibular rehabilitation after stroke are needed.
