Obstacle avoidance training for individuals with stroke: a systematic review and meta-analysis

Area of Science:

• Neurorehabilitation
• Movement Science

Background:

• Stroke significantly impairs locomotor ability, affecting gait speed, balance, and fall risk.
• Current rehabilitation strategies aim to restore functional mobility in stroke survivors.

Purpose of the Study:

• To evaluate the effectiveness of obstacle avoidance training as a standalone intervention for improving locomotor function in individuals post-stroke.
• To synthesize evidence from randomized controlled trials on obstacle avoidance training's impact on gait and balance.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials.
• Searched multiple databases (MEDLINE, EMBASE, CENTRAL, ICTRP, PEDro) up to December 2018.
• Included participants with various stroke types and phases, analyzing gait speed, composite gait ability, and balance.

Main Results:

• Two trials with 49 participants were included; results showed no significant difference in gait speed or subjective balance between training and control groups.
• The certainty of evidence for all outcomes was determined to be very low.
• Obstacle avoidance training alone demonstrated minimal to no positive effect on measured locomotor abilities.

Conclusions:

• Obstacle avoidance training, when used alone, may not be effective in improving locomotor ability in individuals with stroke.
• The lack of demonstrated effectiveness could be due to insufficient training duration or the limited quality of existing studies.
• Further high-quality research is recommended to clarify the role of obstacle avoidance training in stroke rehabilitation.