Effects of Visual Biofeedback Therapy on Postural Balance of Stroke Patients

Purpose: Postural balance deficit is one of the common post-stroke disabilities. Providing visual biofeedback while balance activities are performed is a way to improve postural balance disorders following stroke. But among the research published, there is incoherency about the positive effects of visual biofeedback therapy. The purpose of this study was to investigate the effects of using visual biofeedback as an adjunct to physical therapy exercises on recovery of postural balance of stroke patients. Methods: A total of thirty-one hemiplegic stroke patients were included in this study and randomly assigned into case and control groups. Both groups received four weeks conventional physical therapy interventions and balance training exercises. During balance training, the case group received visual biofeedback, whereas the control group did not receive visual information. Balance performance of stroke patients were examined quantitatively using the Equi-Test testing system and Biodex stability system, walking performance was evaluated by Timed Up and Go tests, and the patients were assessed using the modified Barthel index for activities of daily living. Data were collected before starting, during, and after completion of the rehabilitation program. Repeated measure analyses of variance were performed to evaluate rehabilitation effects and independent samples T tests were done to quantify the effects of visual biofeedback. Results: No significant differences between the groups were detected in any of the outcome variables after completion of the program. Noticeable improvements were found in dynamic balance function, mobility, and activities of daily living of both groups, whereas no statistically significant improvements were found in static balance after rehabilitation. Conclusion: Both rehabilitation protocols created advances in the postural control system of stroke patients. Visual biofeedback balance training did not produce extra advantage for balance ability of participants who received this treatment program in comparison with those who were treated without visual biofeedback. The results showed that dynamical tasks scores and activitybased measures better than static balance measures reflect the recovery effects.