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The effects of different structured exercise interventions on motor function in patients with stroke: a Bayesian
Lin Shen1, Mingyuan Jia2, Jia Zhang3
1Faculty for Physical Education, Zhejiang Yuexiu University, Shaoxing, Zhejiang, China.
Background And Purpose:
Previous studies have compared the effects of exercise interventions on post-stroke motor function; however, evidence comparing different exercise modalities remains limited, particularly for balance outcomes assessed using different measurement scales. This study aimed to compare the effects of structured exercise modalities on balance ability (BA), 10-m walking speed (10MWS), the 6-min walk test (6MWT), and the Timed Up and Go test (TUG) in patients with stroke and to identify interventions supported by the overall body of evidence.
Methods:
Six electronic databases were systematically searched from inception to May 2025 for randomized and non-randomized controlled trials. A Bayesian network meta-analysis synthesized direct and indirect evidence. Intervention rankings were estimated using the surface under the cumulative ranking curve, and the certainty of evidence was evaluated.
Results:
Sixty randomized controlled trials were included. Upper limb exercise, task-specific training, and balance-enhancing training (BET) significantly improved BA. Aerobic exercise (AE) significantly improved 10MWS. Aquatic exercise, AE, and multicomponent exercise (ME) significantly improved 6MWT, whereas ULE and mind-body exercise (MBE) improved TUG performance. Considering both comparative effectiveness and certainty of evidence, BET was preferred for BA, AE for 10MWS, AE and ME for 6MWT, and MBE for TUG.
Conclusion:
Different exercise modalities ranked highest for different motor function outcomes in patients with stroke, indicating that no single intervention was consistently optimal across all outcomes. Considering both the intervention rankings and the certainty of evidence, BET may be preferred for BA, AE for 10MWS, AE and ME for 6MWT, and MBE for TUG.