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Rehabilitation for balance impairment in patients after stroke: a protocol of a systematic review and network meta-analysis
  1. Juan Li1,
  2. Dongling Zhong1,
  3. Jing Ye2,
  4. Mingxing He1,
  5. Xicen Liu1,
  6. Hui Zheng2,
  7. Rongjiang Jin1,
  8. Shao-lan Zhang3
  1. 1 School of Health Cultivation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
  2. 2 School of Acupuncture-Moxibustion and Tuina/The Third Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
  3. 3 Immunology Teaching and Research Section, Chengdu Medical College, Chengdu, China
  1. Correspondence to Dr Rongjiang Jin; cdzyydxjrj{at}


Introduction Multiple rehabilitation therapies have been reported to be effective for poststroke balance impairment. However, the comparative effectiveness of these rehabilitation therapies is still unclear. Therefore, the aim of this study is to summarise evidence and identify the most effective rehabilitation therapy for poststroke balance impairment.

Methods and analysis The following databases will be searched: China Biology Medicine, China National Knowledge Infrastructure, Wan Fang Data, the Chinese Science and Technology Periodical Database, Medline, Excerpt Medical Database (EMBASE), Web of Science, the Cochrane Library, from inception to June 2019. All randomised controlled trials that have used rehabilitation interventions to treat poststroke balance impairment will be included. The primary outcomes are the Berg Balance Scale, the Fugl-Meyer Assessment (balance), the Postural Assessment Scale for Stroke, as well as the function in sitting test, the Sitting Balance Scale, the Ottawa Sitting Scale, the Activities-specific Balance Confidence Scale, the Overall Balance Index and the Brunel Balance Assessment. The secondary outcomes include the Barthel Index, the Functional Ambulation Category Scale, fall rates, the Timed Up and Go test, the MOS 36-Item Short-Form Health Survey, and adverse events. To ensure that all relevant studies are included without personal bias, study selection, data extraction and quality assessment will be performed independently by two reviewers. Risk of bias will be assessed with the Cochrane risk of bias assessment tool. Review Manager V.5.3 software will be used to make bias risk diagram and pairwise meta-analysis, while network data synthesis will be performed using WinBUGS V.1.4.3 and R software.

Ethics and dissemination Ethics approval is not required for systematic review and network meta-analysis. The results will be submitted to a peer review journal or at a conference.

Trial registration number PROSPERO (CRD 42018107441).

  • rehabilitation medicine
  • stroke medicine
  • therapeutics
  • complementary medicine

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  • Contributors JL, DZ and JY contributed equally to the work as first authors. Study concept and design: RJ and S-lZ. Acquisition of data: JL, DZ, MH, HZ and XL. Drafting of the manuscript: JL, DZ and JY. Critical revision of the manuscript for important intellectual content: all authors. Supervision: RJ. All authors approved the publication of this protocol.

  • Funding National Natural Science Foundation of China (grant numbers 81674047 and 81704137).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.

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