Effects of Robot-Assisted Gait Training on Balance and Fear of Falling in Patients With Stroke: A Randomized Controlled Clinical Trial.

Abstract

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. 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. 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. Objective assessment indicated that combined treatments in subacute and chronic stroke rehabilitation enhance balance and reduce fear of falling more effectively than isolated approaches.