Physical Exercise Reduces Fall-Related Outcomes Among People With Stroke: A Systematic Review and Meta-Analysis

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ID: 328840
2026
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Abstract
IMPORTANCE: Stroke markedly increases fall risk. Physical exercise is a potential approach to reducing falls poststroke. OBJECTIVE: The objective was to evaluate the effect of physical exercise on falls in people with stroke, and to examine participant and exercise protocol characteristics that may affect treatment response. DESIGN: This was a systematic review and meta-analysis of randomized controlled trials. SETTING: Following the PRISMA guidelines, PubMed, CINAHL, Cochrane Database, PsycINFO, Embase, and Web of Science databases were systematically searched. PARTICIPANTS: People with stroke were studied. INTERVENTION: Physical exercise training was the intervention examined in this systematic review. MAIN OUTCOMES AND MEASURES: Number of falls/injurious falls/fallers were the outcomes examined. RESULTS: Eighteen studies (1536 participants) were included. Overall, physical exercise significantly reduced the number of falls by 39% (incidence rate ratio (IRR = 0.61, 95% CI = [0.47, 0.78]). The effect on the number of injurious falls (IRR = 0.63, 95% CI = [0.37, 1.05]) and fallers (IRR = 0.88; 95% CI = [0.73, 1.0]) was less apparent. Exploratory subgroup analyses revealed that programs focusing on balance training and those integrating physical exercise with cognitive components (eg, dual-task training/mind-body exercise) were most effective, compared with walking training, combined balance/walking training, and strength training. People in the chronic stage of stroke and with mild to moderate disability may benefit more from exercise. CONCLUSIONS: Physical exercise is effective in improving fall-related outcomes among people with stroke, particularly for people in the chronic stage with mild/moderate disability levels may gain more benefits. Physical exercise programs incorporating balance training and cognitive components may be more effective for fall prevention. RELEVANCE: This results of this systematic review provide insight into exercise training for fall prevention in stroke rehabilitation.
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Authors Xun Li, Yuk Kwan Chan, Yiu Lam Tong, Jingwen Zhuang, Fangfei Xiong, Stanley Hung, Hei Yuen Wan, Ching Hei Wong, Ka Yu Wong, Austen Cheuk Fung Li, Tiev Miller, Marco Y.C. Pang
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Journal Physical Therapy
Year 2026
DOI
10.1093/ptj/pzag098
URL
https://academic.oup.com/ptj/advance-article-pdf/doi/10.1093/ptj/pzag098/71123210/pzag098.pdf
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