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Optimal exercise prescription for balance after stroke: a Bayesian dose-response network meta-analysis
Chunbai Xue Yang1, Yang Xu1, Zhongwei Zhao2
1School of Physical Education, Bohai University, Jinzhou, Liaoning, China.
Frontiers in Neurology
|April 29, 2026
Summary
Exercise significantly improves post-stroke balance, with a minimum effective dose of 270 METs-min/week. Higher doses may offer diminishing returns, suggesting moderate-intensity training is optimal for recovery.
Area of Science:
- Neurorehabilitation
- Exercise Science
- Clinical Trials
Background:
- Post-stroke balance impairment is a significant issue, leading to falls and disability.
- Current exercise prescriptions lack standardization, making optimal dose determination challenging.
Purpose of the Study:
- To determine the dose-response relationship between exercise and balance improvement in stroke survivors.
- To identify the minimum effective exercise dose and optimal dose range for maximal benefit.
Main Methods:
- Bayesian model-based dose-response meta-analysis of 42 randomized controlled trials.
- Primary outcome: Berg Balance Scale (BBS).
- Searched multiple databases up to December 2025; assessed risk of bias and certainty of evidence.
Main Results:
- A non-linear dose-response relationship was observed, peaking around 1,200 METs-min/week, with potential decline at higher doses.
- The minimum credible effective dose was approximately 270 METs-min/week.
- Resistance training and water-based exercise showed the largest pooled benefits.
Conclusions:
- Exercise is effective for improving balance after stroke, with 270 METs-min/week as the minimum effective dose.
- Moderate-intensity training, particularly resistance and water-based exercises, is recommended.
- High-intensity interval training (HIIT) currently shows uncertain benefits and is not recommended as a first-line option.
Keywords:
Berg Balance Scaleaerobic exercisebalanceexercise doseexercise therapyresistance trainingstrokestroke rehabilitationMore Related Videos
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