The purpose of this study was to conduct SR by MA to compare the effects of high-tech and low-tech sitting training on sitting balance ability in stroke patients.
Pubmed, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), Cumulative Index to Nursing and Allied Health Literature (CINAHL) were used to search for randomized controlled trials (RCTs). Two reviewers independently screened articles and conducted data extraction. Differences in the effects of high-tech versus low-tech sitting training on sitting balance ability (Trunk Impairment Scale; TIS) in stroke patients were evaluated. In this study, studies that included training in the supine position were excluded and only training in the sitting position was selected. The MA was performed using Review Manager version 5.4 for statistical comparison. In this study, when studies were divided by stage (acute, subacute, and chronic), more than two studies were identified for each of high-tech and low-tech only for chronic. Therefore, the first, data from trials that included a seated training group with the device and a seated training control group without the device were combined to analyze the effects of sitting training with the device on sitting balance ability. Next, a subgroup analysis was performed to examine differences by stage (chronic) and device type (High-tech vs. Low-tech).
8 studies (201 participants) were included in the MA. Two studies of low-tech (Balance Pad, Dynamic Ball Cushion) sitting training in chronic stroke patients were data integrated, and a total of 45 participants were included in these studies. The resulting SMD was 1.09 (95% confidence interval: 0.36-1.82). Thus, this result was statistically significant (p = 0.003). Next, 6 studies of high-tech (electrical stimulation, electrical vertical board, vibration, visual feedback, robot, video game) sitting training in chronic stroke patients were data-integrated, and these studies included a total of 156 participants. The resulting SMD was 0.61 (95% confidence interval: 0.12-1.11). Thus, this result was statistically significant. (p = 0.02). However, no significant difference was identified between High-tech and Low-tech.
In the MA of this study, no significant differences were identified between Low-tech and High-tech. There are a few reports in the Cochrane Library that show no difference between high-tech interventions such as Virtual Reality for gait in stroke patients compared to classical interventions. Further clinical trials of high-tech sitting training interventions are needed to validate their effectiveness and establish evidence.
This study has important implications for determining sitting training interventions for sitting balance ability in stroke patients.
High-tech
Sitting balance ability
