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Stroke – Improved balance

Evidence Summary
Several studies which have used physical activity programmes involving elements of cardiorespiratory fitness, flexibility, strength training, balance training and “functional training” elements (such as rising from a chair) have been shown to result in improvements in several different measures of balance in people following stroke. This would suggest that a range of different types of physical activity might be helpful in improving balance following stroke.

Quality of Evidence
Grade A-This recommendation comes from a synthesis of studies in the form of a Cochrane review and thus can be considered of high quality.

Strength of Recommendation
Grade 1- This recommendation comes from a synthesis of studies in the form of a Cochrane review and thus can be considered strong

Conclusion
Physical activity of a variety of different kinds following stroke can improve balance. Concern regarding falling is common after stroke and so promoting activities which can improve balance may be an important part of improving overall quality of life and empowerment.
References
• Saunders DH, Sanderson M, Hayes S, Johnson L, Kramer S, Carter DD, Jarvis H, Brazzelli M, Mead GE. Physical fitness training for stroke patients Cochrane Database of Systematic Reviews 2020, Issue 3. Art. No.: CD003316. DOI: 10.1002/14651858.CD003316.pub7.
• Mead GE, Greig CA, Cunningham I, Lewis SJ, Dinan S, Saunders DH, et al. Stroke: a randomised trial of exercise or relaxation. Journal of the American Geriatrics Society 2007; 55(6):892–9
• Shin WS, Lee SW, Lee YW, Choi SB, Song CH. Effects of combined exercise training on balance of hemiplegic stroke patients. Journal of Physical Therapy Science 2011;23(4): 639–43.

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