Functional Balance and Postural Control Improvements in Patients With Stroke After Noninvasive Brain Stimulation: A Meta-analysis

Objectives The postural imbalance poststroke limits individuals’ walking abilities as well as increase the risk of falling. We investigated the short-term treatment effects of noninvasive brain stimulation (NIBS) on functional balance and postural control in patients with stroke. Data Sources We started the search via PubMed and the Institute for Scientific Information’s Web of Science on March 1, 2019 and concluded the search on April 30, 2019. Study Selection The meta-analysis included studies that used either repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) for the recovery of functional balance and postural control poststroke. All included studies used either randomized controlled trial or crossover designs with a sham control group. Data Extraction Three researchers independently performed data extraction and assessing methodological quality and publication bias. We calculated overall and individual effect sizes using random effects meta-analysis models. Data Synthesis The random effects meta-analysis model on the 18 qualified studies identified the significant positive effects relating to NIBS in terms of functional balance and postural control poststroke. The moderator-variable analyses revealed that these treatment effects were only significant in rTMS across patients with acute, subacute, and chronic stroke whereas tDCS did not show any significant therapeutic effects. The meta-regression analysis showed that a higher number of rTMS sessions was significantly associated with more improvements in functional balance and postural control poststroke. Conclusions Our systematic review and meta-analysis confirmed that NIBS may be an effective option for restoring functional balance and postural control for patients with stroke.