Effects of Exercise Therapy on Postural Instability in XXXX : A Meta-analysis.

@entity1 @entity7126 @entity409 @entity12605 @entity191 @entity1344
BACKGROUND AND PURPOSE: Exercise therapy is a common intervention for improving postural stability. The purpose of this meta-analysis was to assess the effect of exercise therapy on postural instability in @entity1 with @entity191 ( @entity191 ) based on the available literature, and to evaluate the efficacy across various types of exercise interventions. DATA SOURCES AND STUDY SELECTION: In January 2015, electronic databases (PubMed, Scopus, PEDro) and study reference lists were searched for randomized controlled trials with moderate or high methodological quality (PEDro score >=  5), investigating the effect of exercise on postural instability in @entity1 with @entity191 . DATA EXTRACTION AND SYNTHESIS: Three reviewers extracted data and assessed quality. MAIN OUTCOME AND MEASURE: Postural stability as measured using the Berg Balance Scale, postural sway, Timed Up and Go, or Functional Reach test. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. RESULTS: Twenty-two trials, with a total of 1072 @entity1 , were eligible for inclusion. The pooled estimates of effects showed @entity1344 ( @entity7126 , 0.23; 95% CI, 0.10-0.36; P < 0.001) after exercise therapy, in comparison with no exercise or sham treatment. Exercise interventions specifically addressing components of @entity409 demonstrated the largest efficacy, with moderate to high effect sizes ( @entity7126 , 0.43; 95% CI, 0.21-0.66; P < 0.001). Little or no beneficial effects were observed for interventions not specifically targeted at postural stability ( @entity7126 , 0.20; 95% CI -0.04 to 0.44; P = 0.11) or for home-based, multicomponent exercise programs ( @entity7126 , 0.02; 95% CI -0.20 to 0.25; P = 0.86). DISCUSSION AND CONCLUSIONS: Exercise therapies specifically addressing @entity409 are an important treatment option for improving postural stability in @entity1 with @entity191 . Future studies should investigate sustainability of the short-term effects and establish the dose-response relationship of balance training in @entity1 with @entity191 .Video abstract available for additional insights from the authors (see Video, @entity12605 , http://links.lww.com/JNPT/A121).
