Effects of Sling Exercise Training on Walking Ability and Balance Function in Patients With Stroke: A Systematic Review and Meta-Analysis.
Wenfu Zhang, Yongqiang Lin, Fan Jiang and 4 others
PMID 41420322WHAT IT FOUND
Daily-living scores and walking endurance were not shown to improve, but suspension-based stroke training (sling exercise, body-weight-supported treadmill and robotic-assisted locomotor training) improved balance and walking.
Key findings
01Pooled trials found a balance benefit of 1.21 on the review's common comparison scale (95% CI 0.61 to 1.81), but the studies varied greatly (I² 89.4%).
02Daily-living scores (0.73) and walking endurance (0.15) were not shown to improve, while lower limb motor function (0.98) and Holden walking ability (1.05) were.
03The pooled studies mixed sling exercise training, body-weight-supported treadmill training and robotic-assisted locomotor training, so the benefit cannot be assigned to sling exercise training alone.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Sample sizes were small (18 to 112 participants per study), so the pooled estimates may be unstable. Blinding of participants and personnel was not possible in most studies, and outcome assessment was blinded in approximately half. Heterogeneity was high for balance and daily-living outcomes (I² 89.4% and 90.4%), so the average effect may not apply to every patient or programme. The review mixed sling exercise training, body-weight-supported treadmill training and robotic-assisted locomotor training, so it cannot identify which component caused the effect. One included study was a case study, although the review planned to include randomized trials. The authors noted publication bias and missing outcome measures in some studies.
Declared interests
This work was supported by the Zhejiang Province Medical and Health Science and Technology Plan County Project and the Wenling City Social Development Science and Technology Key Project. The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that sling exercise training alone improves daily living or walking endurance. The pooled daily-living and walking-endurance results were not shown to improve, and the review mixed sling exercise with body-weight-supported treadmill and robotic-assisted locomotor training.