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Balance Interventions to Improve Upright Balance Control and Balance Confidence in People with Motor-Incomplete Spinal Cord Injuries or Diseases: A Systematic Review and Meta-Analysis

Natasha Benn, Hope Jervis-Rademeyer, W. H. Souza, Maureen Pakosh, Elizabeth L. Inness, Kristin E. Musselman

Archives of Physical Medicine and Rehabilitation, 2024

500 participants · 9 citations

Abstract

OBJECTIVES

To assist with clinical decision-making, evidence syntheses are needed to demonstrate the efficacy of available interventions, and examine the intervention components and dosage parameters. This systematic review and meta-analysis describes the efficacy, components and dosage of interventions targeting upright balance control, balance confidence and/or falls in adults with motor incomplete spinal cord injuries/diseases (SCI/D).

DATA SOURCES

A search strategy following the PICO framework was developed. Six databases were searched: APA PsychInfo, CINAHL, Embase, Emcare Nursing, Web of Science CC, and Medline.

STUDY SELECTION

Title, abstract and full-text screening were conducted by two researchers independently. Inclusion criteria included: 1) adults with chronic, motor-incomplete SCI/D; 2) physical intervention targeting upright postural control; and 3) clinical and/or biomechanical measures of upright balance control and/or balance confidence and/or documentation of falls.

DATA EXTRACTION

Participant characteristics, balance intervention details, adverse events and study results were extracted. The Downs and Black Checklist assessed methodological quality. Meta-analyses on pre-post intervention outcomes and a meta-regression of dosage were completed. The GRADE approach was used to evaluate the quality of the evidence.

DATA SYNTHESIS

The search returned 1,664 unique studies; 26 were included. Methodological quality was moderate to good. Participants were 500…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 500 participants or records.

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