Interactive Posturographic Balance Training Added to Conventional Rehabilitation in Chronic Stroke

Stroke is a major cause of long-term disability and frequently results in persistent impairments in postural control and balance. In individuals with chronic stroke, altered sensory integration and impaired motor coordination contribute to increased fall risk and reduced functional independence. Although conventional rehabilitation programs address strength, mobility, and functional training, balance deficits may remain due to insufficient multisensory challenge and limited task-specific feedback.

Biofeedback-based interactive posturographic systems provide real-time visual and sensory feedback during standing tasks and systematically challenge postural control under varying sensory conditions. Such interventions may enhance motor learning and promote adaptive sensory reweighting mechanisms by exposing individuals to controlled visual deprivation and head-position alterations.

This prospective, single-blind randomized controlled study was conducted in individuals with chronic stroke (>6 months post-event). Participants were randomly assigned to receive either conventional rehabilitation alone or conventional rehabilitation combined with interactive posturographic balance training. The intervention period lasted eight weeks, with sessions conducted five days per week.

The primary objective of the study was to determine whether adding biofeedback-based interactive posturographic balance training improves clinical balance performance. Secondary objectives included evaluating effects on fall risk, functional independence, and psychological status.

Inclusion criteria

• At least 6 months had elapsed since stroke onset
• They were ambulatory prior to stroke
• They were able to stand independently for at least 2 minutes
• Mini-Mental State Examination (MMSE) score ≥22

Exclusion criteria

• Medical conditions contraindicating participation in an exercise program
• Additional disorders affecting balance assessment (vertebrobasilar or peripheral vestibular insufficiency, significant visual impairment, neglect, cognitive impairment, major lower extremity contracture, neuromuscular disease, other neurological pathology, impaired joint position sense)
• Previous history of stroke
• Cerebellar involvement (dysmetria, dysdiadochokinesia, ataxia)