The Effects of Robot-Asssissted Gait Training on Balance and Fear of Falling in Patients with Stroke: A Randomized Controlled Clinical Trial

ABSTRACT Objective The aim of this study was compare the effects of Combined Training (CombT), which included Robot-Assisted Gait Training in addition to Traditional Balance Training (TBT), and TBT alone on balance and fear of falling (FoF) in patients with stroke based on objective assessment methods. Design Patients were randomized into CombT Group (CombTG) (n = 21) and TBT Group (TBTG) (n = 21) for duration of 5-weeks. Balance were assessed with EncephaLog App recorded stand-up time (SUT), sit-down time (SDT), and directional sways during walking, Berg Balance Scale (BBS) and Timed Up and Go Test (TUG). International Fall Efficacy Scale (FES-I) measured fear of falling (FoF). Fugl Meyer Assessment-Lower Extremity (FMA-LE) assessed limb impairment. Foot posture were assessed with Foot Posture Index (FPI-6). Results After the treatments, EncephaLog sways (anterior, medial, lateral: P = 0.04, P = 0.01, P = 0.02), SUT ( P = 0.006), SDT ( P = 0.002); BBS ( P < 0.001); FES-I ( P = 0.002) improved in CombTG. TUG ( P = 0.01) and FMA-LE ( P < 0.001) improved in TBTG. SUT ( P = 0.01) and SDT ( P = 0.04) showed statistically significant improvement in CombTG compared to TBTG; FMA-LE ( P = 0.002) demonstrated statistically significant improvement in TBTG compared to CombTG. Conclusion Objective assessment indicated that combined treatments in subacute and chronic stroke rehabilitation enhance balance and reduce FoF more effectively than isolated approaches.