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

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.