Resistance training combined with electrical stimulation or stretching improves balance, motor function, and walking in stroke patients.

This systematic review and Bayesian network meta-analysis focused on stroke patients presenting with lower-limb dysfunction. The analysis pooled data from a total sample size of 2448 participants to compare various rehabilitation interventions. The setting for the included studies was not reported in the source data. The primary objective was to assess the efficacy of different training modalities on balance, lower-limb motor function, and walking ability.

The interventions evaluated included resistance training alone or combined with other rehabilitation modalities, specifically electrical stimulation therapy and stretching training. The comparator groups consisted of daily care or resistance training alone. The study utilized Bayesian network meta-analysis techniques to rank the efficacy of these different approaches based on the Surface Under the Cumulative Ranking Curve (SUCRA) values.

Regarding the primary outcome of balance, resistance training combined with electrical stimulation therapy produced the greatest improvements. This intervention achieved a SUCRA value of 91.13%. For the outcome of lower-limb motor function, resistance training combined with electrical stimulation therapy also produced the greatest improvements, with a SUCRA value of 79.70%. In terms of walking ability, resistance training combined with stretching training showed the best enhancement, achieving a SUCRA value of 96.34%.

No specific absolute numbers, p-values, or confidence intervals were reported for these primary outcomes in the source data. Similarly, no data were reported regarding secondary outcomes, adverse events, serious adverse events, discontinuations, or overall tolerability. Consequently, specific safety profiles and rates of discontinuation could not be quantified or described from the provided evidence.

The practice relevance of this analysis suggests that integrating resistance training with targeted adjunctive training yields superior therapeutic outcomes. This supports individualized, evidence-based strategies for optimizing lower-limb recovery after stroke. However, the lack of reported safety data and the absence of specific p-values or confidence intervals limit the ability to fully assess the statistical certainty or risk-benefit profile of these interventions.

Key methodological limitations include the lack of reported funding or conflicts of interest and the absence of specific study settings. The certainty note and causality note were not reported. These gaps prevent a definitive conclusion regarding the causal nature of the observed improvements and the robustness of the statistical evidence. Clinicians should interpret these findings as indicative of potential efficacy rather than definitive proof of superiority without further data on safety and statistical significance.

Questions remain unanswered regarding the long-term durability of these gains, as the follow-up period was not reported. Additionally, the specific protocols for electrical stimulation and stretching, including frequency, intensity, and duration, were not detailed in the input data. Future research should aim to clarify these parameters and provide comprehensive safety data to fully inform clinical decision-making.