Effectiveness of Hydrotherapy on Balance and Paretic Knee Strength in Patients With Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. (May 2020)

• Record Type: Journal Article
• Authors: Chae, Choong Sik; Jun, Ji Hyun; Im, Sun; Jang, Yongjun; Park, Geun-Young
• Is Part Of: American journal of physical medicine & rehabilitation. Volume 99:Number 5(2020)
• Publication Date: 2020-05
• Subjects: Hydrotherapy -- Stroke Rehabilitation -- Postural Balance -- Meta-analysis; Rehabilitation -- Periodicals; Medicine, Physical -- Periodicals; 617.062
• DOI: 10.1097/PHM.0000000000001357
• Languages: English
• ISSNs: 0894-9115

Abstract

Abstract : Objective: The aim of the study was to compare the effects of hydrotherapy and land-based conventional therapy on postural balance and knee strength in stroke patients. Designs: A comprehensive search was done via databases (PubMed, EMBASE, and Web of Science) until April 12, 2019, to select randomized controlled trials. The methodological quality was assessed by the PEDro scale. Berg Balance Scale was pooled as the primary outcome and Forward Reach Test, Timed Up and Go test, and paretic knee flexor and knee extensor torque as secondary outcomes. Results: Eleven articles were included. Pooled results showed that hydrotherapy was more beneficial in stroke patients on Berg Balance Scale (mean difference = 1.60, 95% confidence interval = 1.00 to 2.19), Forward Reach Test (mean difference = 1.78, 95% confidence interval = 0.73 to 2.83), Timed Up and Go test (mean difference = −1.41, 95% confidence interval: −2.44 to 0.42), and knee extensor torque (mean difference = 6.14, 95% confidence interval = 0.59 to 11.70) than conventional therapy. In subgroup analysis according to stroke-onset duration, hydrotherapy for chronic stroke patients exhibited significant effectiveness on Berg Balance Scale (mean difference = 1.61, 95% confidence interval = 1.00–.21); no significant effect was observed in subacute stroke patients (mean difference = 1.04, 95% confidence interval = −2.62 to 4.70). Conclusion: Stroke patients showed improvement in postural balance and paretic knee extensor strength with hydrotherapy. Hydrotherapy exhibited significant effects on improving postural balance in chronic patients than in subacute patients. Abstract : Supplemental digital content is available in the text.