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

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.