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Meta-Analysis
. 2017 Mar 29;12(3):e0174522.
doi: 10.1371/journal.pone.0174522. eCollection 2017.

Effects of different lower-limb sensory stimulation strategies on postural regulation-A systematic review and meta-analysis

Mei Teng Woo  1   2 , Keith Davids  3 , Jarmo Liukkonen  1 , Dominic Orth  4 , Jia Yi Chow  5 , Timo Jaakkola  1
Affiliations
Meta-Analysis

Effects of different lower-limb sensory stimulation strategies on postural regulation-A systematic review and meta-analysis

Mei Teng Woo et al. PLoS One. .

Abstract

Systematic reviews of balance control have tended to only focus on the effects of single lower-limb stimulation strategies, and a current limitation is the lack of comparison between different relevant stimulation strategies. The aim of this systematic review and meta-analysis was to examine evidence of effects of different lower-limb sensory stimulation strategies on postural regulation and stability. Moderate- to high- pooled effect sizes (Unbiased (Hedges' g) standardized mean differences (SMD) = 0.31-0.66) were observed with the addition of noise in a Stochastic Resonance Stimulation Strategy (SRSS), in three populations (i.e., healthy young adults, older adults, and individuals with lower-limb injuries), and under different task constraints (i.e., unipedal, bipedal, and eyes open). A Textured Material Stimulation Strategy (TMSS) enhanced postural control in the most challenging condition-eyes-closed on a stable surface (SMD = 0.61), and in older adults (SMD = 0.30). The Wearable Garments Stimulation Strategy (WGSS) showed no or adverse effects (SMD = -0.68-0.05) under all task constraints and in all populations, except in individuals with lower-limb injuries (SMD = 0.20). Results of our systematic review and meta-analysis revealed that future research could consider combining two or more stimulation strategies in intervention treatments for postural regulation and balance problems, depending on individual needs.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Summary of the search strategy and selection process based on included and excluded studies.
Fig 2
Fig 2. Risk of bias summary.
Fig 3
Fig 3. Funnel plot of all studies included in the meta-analysis.
Fig 4
Fig 4. Forest plots for single-leg standing balance task.
Task: Single-Leg Stand; Vision: Eyes open and closed; Surface: Stable and foam; Population: Healthy young; Older adults; Lower-limbs’ injuries.
Fig 5
Fig 5. Forest plots for double-limbs standing balance task.
Task: Double-limbs standing; Vision: Eyes open and closed; Surface: Stable and foam; Population: Healthy young; Older adults; Lower-limbs’ injuries.
Fig 6
Fig 6. Forest plots for the young and healthy population.
Population: Young and healthy; Vision: Eyes open and closed; Surface: Stable; Task: Single-leg and double-limbs standing tasks.
Fig 7
Fig 7. Forest plots for the older adults population.
Population: Older adults; Vision: Eyes open and closed; Surface: Stable; Task: Single-leg and double-limbs standing tasks.
Fig 8
Fig 8. Forest plots for the lower-limbs’ injuries population.
Population: Lower-limbs’ injuries; Vision: Eyes open and closed; Surface: Stable; Task: Single-leg and double-limbs standing tasks.
Fig 9
Fig 9. Forest plots for eyes open condition.
Vision: Eyes open; Surface: Stable; Task: Single-leg and double-limbs standing tasks; Population: Healthy young; Older adults; Lower-limbs’ injuries.
Fig 10
Fig 10. Forest plots for eyes- closed condition.
Vision: Eyes- closed; Surface: Stable; Task: Single-leg and double-limbs standing tasks; Population: Healthy young; Older adults; Lower-limbs’ injuries.
See this image and copyright information in PMC

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