Effect of aquatic therapy on balance and gait in stroke survivors: a systematic review and meta-analysis

Nayak, P ORCID: https://orcid.org/0000-0001-8872-6858, Mahmood, A ORCID: https://orcid.org/0000-0002-2803-3598, Natarajan, M, Hombali, A, Prashanth, CG and Solomon, JM (2020) Effect of aquatic therapy on balance and gait in stroke survivors: a systematic review and meta-analysis. Complementary Therapies in Clinical Practice, 39. 101110. ISSN 1744-3881

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Abstract

Background: The evidence on aquatic therapy (AT) for improving balance and gait deficits post-stroke is unclear. Therefore, this study aimed to determine the effect of AT on balance and gait in stroke survivors. Methods: We searched CINAHL, PubMed, Web of Science, Aqua4balance, Ewac, Cochrane, and EMBASE databases from inception to 1st November 2019. Results: Eleven studies with 455 participants were included for the review. Meta-analysis showed that AT was effective for improving balance (MD 3.23, 95% CI 1.06, 5.39; p = 0.004; I2 = 61%) and gait speed (MD 0.77, 95% CI 0.25, 1.29; p = 0.004; I2 = 0%) when delivered alone. AT was effective in improving cadence (MD 4.41, 95% CI 0.82, 8.00; p = 0.02; I2 = 68%) when delivered as an adjunct to land-based therapy. Conclusion: AT may be used to improve balance and gait after stroke; however, the evidence to support its use is still low.