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The effects of balance training on gait late after stroke: a randomized controlled trial [with consumer summary]
Yavuzer G, Eser F, Karakus D, Karaoglan B, Stam HJ
Clinical Rehabilitation 2006 Nov;20(11):960-969
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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.

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