Effects of Robot-Assisted Gait Training on Balance and Fear of Falling in Patients With Stroke: A Randomized
Merve Sevinc Gunduz1, Rustem Mustafaoglu, Ibrahim Halil Ural
1From the Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakıf University, Istanbul, Türkiye (MSG); Department of Physiotherapy and Rehabilitation, Institute of Graduate Studies, Istanbul University-Cerrahpasa, Istanbul, Türkiye (MSG); Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Türkiye (RM); and Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Beykent University, Istanbul, Türkiye (IHU).
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.
