Complementary therapies in clinical practice · 2026
Comparative effectiveness of traditional vs. emerging rehabilitation exercises in enhancing daily living activities and lower extremity function among stroke survivors: A network meta-analysis.
СтатьяNetwork Meta-AnalysisСравнительное исследованиеОбзорПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Zhao Zhenhui, Ma Chao, Wang Xianliang
Аннотация
BACKGROUND AND PURPOSE: Post-stroke lower limb motor dysfunction significantly impairs activities of daily living (ADL). The present study provides a comparative analysis of various exercise interventions to determine their relative effectiveness in improving lower extremity function and ADL post-stroke.
METHODS: We systematically searched six databases for randomized controlled trials published from database inception through December 2024. After quality assessment, a network meta-analysis was conducted to evaluate comparative efficacy, with intervention hierarchies ranked using the surface under the cumulative ranking curve (SUCRA).
RESULTS: A total of 12,326 studies were identified, among which 54 randomized controlled trials involving 2104 stroke survivors met inclusion criteria. The key findings revealed distinct optimal interventions for each functional domain. Motor imagery therapy was identified as the most effective approach for lower limb function (SUCRA = 92.5%). For ADL, aquatic exercise showed the highest probability of being the most beneficial intervention (SUCRA = 70.9%). Finally, mirror therapy demonstrated superior efficacy for both balance (SUCRA = 92.8%) and walking endurance (SUCRA = 92.1%).
CONCLUSION: Multiple exercise interventions demonstrate clinically meaningful benefits for post-stroke lower limb function and ADL performance. Motor imagery therapy may represent the optimal exercise modality for improving lower limb function, while aquatic exercise appears to be the most promising intervention for enhancing ADL. Mirror therapy demonstrated superior efficacy in improving both balance and gait function. These findings provide evidence-based guidance for personalized neurorehabilitation protocols.
METHODS: We systematically searched six databases for randomized controlled trials published from database inception through December 2024. After quality assessment, a network meta-analysis was conducted to evaluate comparative efficacy, with intervention hierarchies ranked using the surface under the cumulative ranking curve (SUCRA).
RESULTS: A total of 12,326 studies were identified, among which 54 randomized controlled trials involving 2104 stroke survivors met inclusion criteria. The key findings revealed distinct optimal interventions for each functional domain. Motor imagery therapy was identified as the most effective approach for lower limb function (SUCRA = 92.5%). For ADL, aquatic exercise showed the highest probability of being the most beneficial intervention (SUCRA = 70.9%). Finally, mirror therapy demonstrated superior efficacy for both balance (SUCRA = 92.8%) and walking endurance (SUCRA = 92.1%).
CONCLUSION: Multiple exercise interventions demonstrate clinically meaningful benefits for post-stroke lower limb function and ADL performance. Motor imagery therapy may represent the optimal exercise modality for improving lower limb function, while aquatic exercise appears to be the most promising intervention for enhancing ADL. Mirror therapy demonstrated superior efficacy in improving both balance and gait function. These findings provide evidence-based guidance for personalized neurorehabilitation protocols.