Effect of aquatic therapy on balance and gait in stroke survivors: A systematic review and meta-analysis

Background: The evidence on aquatic therapy (AT) for improving balance and gait deficits post-stroke is unclear. Therefore, this study aimed to determine the effect of AT on balance and gait in stroke survivors.

Methods: We searched CINAHL, PubMed, Web of Science, Aqua4balance, Ewac, Cochrane, and EMBASE databases from inception to 1^st November 2019.

Results: Eleven studies with 455 participants were included for the review. Meta-analysis showed that AT was effective for improving balance (MD 3.23, 95% CI 1.06, 5.39; p = 0.004; I² = 61%) and gait speed (MD 0.77, 95% CI 0.25, 1.29; p = 0.004; I² = 0%) when delivered alone. AT was effective in improving cadence (MD 4.41, 95% CI 0.82, 8.00; p = 0.02; I² = 68%) when delivered as an adjunct to land-based therapy.

Conclusion: AT may be used to improve balance and gait after stroke; however, the evidence to support its use is still low.