The effects of balance training on gait late after stroke: a randomized controlled trial

Abstract

Objective: To investigate the effects of balance training, using force platform biofeedback, on quantitative gait characteristics of hemiparetic patients late after stroke. Design: Randomized, controlled, assessor-blinded trial. Setting: Rehabilitation ward and gait laboratory of a university hospital. Subjects: Forty-one patients (mean (standard deviation; SD) age of 60.9 (11.7) years) with hemiparesis late after stroke (median time since stroke six months) were randomly assigned to an experimental or a control group. Interventions: The control group ( n = 19) participated in a conventional stroke inpatient rehabilitation programme, whereas the experimental group ( n = 22) received 15 sessions of balance training (using force platform biofeedback) in addition to the conventional programme. Main outcome measures: Selected paretic side time-distance, kinematic and kinetic gait parameters in sagittal, frontal and transverse planes were measured using a three-dimensional computerized gait analysis system, one week before and after the experimental treatment programme. Results: The control group did not show any statistically significant difference regarding gait characteristics. Pelvic excursion in frontal plane improved significantly ( P = 0.021) in the experimental group. The difference between before-after change scores of the groups was significant for pelvic excursion in frontal plane ( P = 0.039) and vertical ground reaction force ( P = 0.030) in favour of experimental group. Conclusion: Balance training using force platform biofeedback in addition to a conventional inpatient stroke rehabilitation programme is beneficial in improving postural control and weight-bearing on the paretic side while walking late after stroke.