Balance training following stroke: effects of task-oriented exercises with and without altered sensory input

The purpose of this study was to compare the effects of a task-oriented exercise program with and without altered sensory input on postural stability in subjects with stroke. Sixteen hemiparetic subjects, at least 6 months post-stroke, were randomly assigned to the experimental or control group, and participated in an 8-week task-oriented exercise program focusing on balance and mobility exercises. Exercises were performed under normal conditions by the control group, and under conditions of vision and surface manipulation by the experimental group. Pre- and post-test assessments involved the measurement of the center of pressure (COP) displacement during double-legged stance and sit-to-stand under four sensory conditions: (1) eyes open, normal surface; (2) eyes open, soft surface; (3) eyes closed, normal surface; and (4) eyes closed, soft surface, as well as the 10-m walking test. Results showed significant improvements (P<0.05) in COP displacement under sensory conditions (1) and (2) for the experimental group only, and limited changes for the sit-to-stand in both groups after training. Significant improvements (P<0.05) were also found in both groups for the walking test. It is concluded that a task-oriented exercise program, assisted by sensory manipulation, is more effective at improving the standing balance of stroke subjects than a conventional task-oriented program.