Assessment of Postural Control and Gait in Chronic Stroke Patients After Treadmill Perturbation-based Training: A Randomized Clinical Trial

Background. After ischemic heart disease, stroke is globally the second leading cause of death and the second most common cause of disability. The rehabilitation of chronic stroke patients increasingly uses advanced technologies, such as treadmill perturbation-based training (TPBT). While the results of studies with TPBT are promising, they are inconclusive due to the limited number of works and inconsistent research methodologies. Therefore, more randomized clinical trials (RCTs) are needed to evaluate TPBT’s efficacy and applicability in post-stroke rehabilitation. This prospective RCT was designed to assess whether and to what extent TPBT can improve postural balance and gait quality and reduce fear of falling in chronic stroke patients. Methods. Fifty individuals at least six months post-stroke were enrolled in the trial and randomly assigned to the experimental group (EG; n = 25) to receive the TPBT or the control group (CG; n = 25) to receive overground gait and balance training. Both groups exercised six times per day for three weeks. Results. The Berg Balance Scale showed post-intervention that postural balance improved significantly in both groups (EG, p=0.001 and CG, p=0.009) but the change did not statistically significantly differentiate the EG from the CG (p=0.256). Significant improvements in walking speed over the distance of 10 meters (p=0.015) and fear of falling (p=0.002) in the CG were not significantly different from those in the EG (p=0.543). Conclusions. TPBT applied to chronic stroke patients improves their postural control comparably to conventional gait and balance training but does not enhance their gait quality.