Nearly half of individuals with stroke experience limitations in community ambulation, and 35.7% of community-dwelling stroke survivors experienced falls while walking, indicating that falls are common during routine daily activities in community settings. Sensory reweighting refers to the ability to appropriately prioritize and integrate sensory inputs to maintain postural stability. Stroke survivors often demonstrate impaired sensory reweighting, characterized by excessive reliance on visual and proprioceptive cues and insufficient integration of vestibular information. This deficit adversely affects postural control and subsequently compromises gait performance and fall risk .In addition, many individuals with stroke exhibit reduced gaze stability during walking and turning, suggesting potential impairments in the vestibulo-ocular reflex (VOR), a key mechanism for maintaining stable vision during head movement. Insufficient gaze stability has been associated with gait disturbances; therefore, deficits in sensory reweighting and VOR function may contrib-ute to limited community ambulation and increased fall risk. Although previous studies have primarily focused on general balance training, few have directly targeted vestibular input. Thus, the effectiveness of vestibular-specific training for improving community ambulation and reducing fall risk in chronic stroke remains unclear. This study aims to investigate the effects of vestibular training on community ambulation and fall risk in individuals with chronic stroke.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
40
Gaze stabilization exercises and balance training under visual and head-movement challenges to stimulate vestibular input and maintain balance.
Strength, posture, gait, and functional training.
Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University
Taipei, Taiwan
Walking Ability Questionnaire
Using Walking Ability Questionnaire to evaluate community ambulation ability.
Time frame: Baseline, 4 weeks after training, and 4-week follow-up
Community Walking Speed
Using a timer to measure average walking speed in the community
Time frame: Baseline, post-intervention, 4 weeks after training, and 4-week follow-up
Taiwan Chinese version of the Falls Efficacy Scale
Using Taiwan Chinese version Falls Efficacy Scale to evaluate fall risk
Time frame: Baseline, 4 weeks after training, and 4-week follow-up
Functional Gait Assessment
Using Functional gait assessment to evaluate walking performance
Time frame: Baseline, 4 weeks after training, and 4-week follow-up
Six-minute Walk Test
Using Six-minute Walk Test to evaluate walking endurance
Time frame: Baseline, 4 weeks after training, and 4-week follow-up
Mini-Balance Evaluation Systems Test
Using Mini-Balance Evaluation Systems Test to evaluate balance performanc
Time frame: Baseline, 4 weeks after training, and 4-week follow-up
Activities-specific Balance Confidence Scale
Using Activities-specific Balance Confidence Scale to evaluate individual's balance confidence in performing daily activities
Time frame: Baseline, 4 weeks after training, and 4-week follow-up
Tinetti Performance-Oriented Mobility Assessment
Time frame: Baseline, 4 weeks after training, and 4-week follow-up
Modified Clinical Test of Sensory Integration and Balance
Using Biodex system to evaluate sensory reweighting ability
Time frame: Baseline, 4 weeks after training, and 4-week follow-up
Dynamic Visual Acuity Test
Using Dynamic Visual Acuity Test to evaluate vestibulo-ocular reflex function
Time frame: Baseline, 4 weeks after training, and 4-week follow-up
Stroke Impact Scale
Using Stroke Impact Scale to evaluate quality of life
Time frame: Baseline, 4 weeks after training, and 4-week follow-up
Gait performance
Using GAITRite system to measure the gait spatiotemporal parameters
Time frame: Baseline, post-intervention, 4 weeks after training, and 4-week follow-up
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