Stroke
Conditions
Keywords
community ambulation, vestibular training, vestibular rehabilitation, fall risk, stroke, dynamic acuity, gait
Brief summary
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.
Interventions
OTHERVestibular training
Gaze stabilization exercises and balance training under visual and head-movement challenges to stimulate vestibular input and maintain balance.
OTHERConventional physical therapy
Strength, posture, gait, and functional training.
Sponsors
National Yang Ming Chiao Tung University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Diagnosis of First-occurrenced stroke * ≥ 6 months after stroke * Ability to walk at least 400 meters with or without the use of a walking assistive device * Mini-Mental State Examination score ≥ 24 * Age between 18 and 80 years
Exclusion criteria
* Other neurological or musculoskeletal conditions affected postural stability * Presence of dizziness or vertigo * Presence of conditions affecting cervical blood flow or limiting cervical range of motion * Visual impairment * Unstable cardiac status or uncontrolled hypertension
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Walking Ability Questionnaire | Baseline, 4 weeks after training, and 4-week follow-up | Using Walking Ability Questionnaire to evaluate community ambulation ability. |
| Community Walking Speed | Baseline, post-intervention, 4 weeks after training, and 4-week follow-up | Using a timer to measure average walking speed in the community |
| Taiwan Chinese version of the Falls Efficacy Scale | Baseline, 4 weeks after training, and 4-week follow-up | Using Taiwan Chinese version Falls Efficacy Scale to evaluate fall risk |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Functional Gait Assessment | Baseline, 4 weeks after training, and 4-week follow-up | Using Functional gait assessment to evaluate walking performance |
| Six-minute Walk Test | Baseline, 4 weeks after training, and 4-week follow-up | Using Six-minute Walk Test to evaluate walking endurance |
| Mini-Balance Evaluation Systems Test | Baseline, 4 weeks after training, and 4-week follow-up | Using Mini-Balance Evaluation Systems Test to evaluate balance performanc |
| Activities-specific Balance Confidence Scale | Baseline, 4 weeks after training, and 4-week follow-up | Using Activities-specific Balance Confidence Scale to evaluate individual's balance confidence in performing daily activities |
| Tinetti Performance-Oriented Mobility Assessment | Baseline, 4 weeks after training, and 4-week follow-up | — |
| Modified Clinical Test of Sensory Integration and Balance | Baseline, 4 weeks after training, and 4-week follow-up | Using Biodex system to evaluate sensory reweighting ability |
| Dynamic Visual Acuity Test | Baseline, 4 weeks after training, and 4-week follow-up | Using Dynamic Visual Acuity Test to evaluate vestibulo-ocular reflex function |
| Stroke Impact Scale | Baseline, 4 weeks after training, and 4-week follow-up | Using Stroke Impact Scale to evaluate quality of life |
| Gait performance | Baseline, post-intervention, 4 weeks after training, and 4-week follow-up | Using GAITRite system to measure the gait spatiotemporal parameters |
Countries
Taiwan
Contacts
CONTACTYea-Ru Yang, PhD
Outcome results
None listed