OBJECTIVE: The aim of this study was compare the effects of combined training, which included robot-assisted gait training in addition to traditional balance training, and traditional balance training alone on balance and fear of falling in patients with stroke based on objective assessment methods. DESIGN: Patients were randomized into combined training group (n = 21) and traditional balance training group (n = 21) for duration of 5 wks. Balance were assessed with EncephaLog App recorded stand-up time, sit-down time, and directional sways during walking, Berg Balance Scale, and Timed Up and Go Test. International Fall Efficacy Scale measured fear of falling. Fugl-Meyer Assessment-Lower Extremity assessed limb impairment. Foot posture was assessed with Foot Posture Index. RESULTS: After the treatments, EncephaLog sways (anterior, medial, lateral: p = 0.04, p = 0.01, p = 0.02), stand-up time (p = 0.006), sit-down time (p = 0.002), Berg Balance Scale (p < 0.001), and International Fall Efficacy Scale (p = 0.002) improved in combined training group. Timed Up and Go Test (p = 0.01) and Fugl-Meyer Assessment-Lower Extremity (p < 0.001) improved in traditional balance training group. Stand-up time (p = 0.01) and sit-down time (p = 0.04) showed statistically significant improvement in combined training group compared to traditional balance training group; Fugl-Meyer Assessment-Lower Extremity (p = 0.002) demonstrated statistically significant improvement in traditional balance training group compared to combined training group. CONCLUSIONS: Objective assessment indicated that combined treatments in subacute and chronic stroke rehabilitation enhance balance and reduce fear of falling more effectively than isolated approaches.

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