Background
Materials and methods
Search strategy
Inclusion criteria
Data extraction
Risk of bias and quality assessment
Statistical and subgroup analysis
Results
Search results
General characteristic of the included studies
Author | Region | No. of patients (n) | Type of exercise | Control | Duration and frequency | Follow-up | Outcomes | Study |
---|---|---|---|---|---|---|---|---|
Binder 2004 | USA | 46/44 | Phase 1: flexibility, balance, coordination, movement speed; phase 2: add progressive resistance training | Core exercise focused on flexibility | 6 months (3 days a week) | 6 months | 3, 5, 6 | RCT |
Hauer 2002 | Germany | 15/13 | Progressive functional training with walking, stepping, or balancing | Motor placebo activities (calisthenics games) | 3 months (3 days a week) | 3 months | 1, 2, 3, 6, 7 | RCT |
Latham 2014 | USA | 120/112 | Standing from a chair, climbing a step | Nutritional education | 6 months (3 days a week) | 9 months | 1, 2, 4, 5, 7 | RCT |
Monticone 2018 | Italy | 26/26 | Balance task-specific training while standing | Walking training and open kinetic chain exercise | 3 weeks (3 days a week) | 12 months | 1, 2, 3, 4, 7 | RCT |
Moseley 2009 | Australia | 80/80 | [Inpatient] Standing up, sitting down, tapping the foot, and stepping onto and off a block | Lower dose exercise (30 min/day) | 4 months (14 days a week) | 4 months | 3, 4, 5 | RCT |
Peterson 2004 | USA | 38/32 | With balance and gait training | Conventional physical therapy | 2 months (2 days a week) | 12 months | 1, 2, 4, 6, 7 | RCT |
Sherrington 1997 | Australia | 20/20 | Stepping exercise with weight-bearing exercise | No treatment | 1 month (7 days a week) | 1 month | 1, 2, 4, 5, 7 | RCT |
Sherrington 2004 | Australia | 40/40 | Sit-to-stand, lateral step-up, forward step-out-and-over, forward foot taps | Non-weight bearing exercise | 4 months (NS) | 4 months | 1, 2, 3, 6, 7 | RCT |
Zheng 2010 | China | 60/60 | With balance and gait training | No treatment | 6 months (3 days a week) | 6 months | RCT |
Risk of bias in included studies
Results of meta-analysis
Overall function
Gait speed
Lower limb strength
ADLs
Performance task scores
HRQoL scores
Publication bias, sensitivity analysis, and subgroup analysis
Subgroup | No. of trials | Standard mean difference (95% CI) | P value | I2 (%) | Test of interaction, P |
---|---|---|---|---|---|
Total | 9 | 0.59 (0.25, 0.93) | 0.001 | 81.9 | |
Training duration | |||||
≤ 3 months | 3 | 0.71 (0.41, 1.01) | 0.000 | 69.3 | 0.106 |
> 3 months | 3 | 0.57 (0.41, 0.72) | 0.000 | 88.2 | |
Risk of bias | |||||
Low | 3 | 0.70 (0.47, 0.94) | 0.000 | 0.0 | 0.028 |
Unclear/high | 3 | 0.54 (0.38, 0.71) | 0.000 | 88.4 | |
Frequency of training | |||||
≤ 3 days a week | 7 | 0.52 (0.37, 0.68) | 0.000 | 82.4 | 0.002 |
> 3 days a week | 2 | 0.86 (0.57, 1.16) | 0.000 | 83.5 | |
Follow-up | |||||
< 6 months | 5 | 0.78 (0.54,1.01) | 0.000 | 57.8 | 0.105 |
≥ 6 months | 1 | 0.50 (0.33,0.67) | 0.000 | 88.1 |