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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Vestibular training group | Experimental | The intervention is a 40-minute session and 3 sessions/week, totaling 4 weeks. |
|
| Conventional physical therapy Group | Active Comparator | The intervention is a 40-minute session and 3 sessions/week, totaling 4 weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Vestibular training | Other | Gaze stabilization exercises and balance training under visual and head-movement challenges to stimulate vestibular input and maintain balance. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Walking Ability Questionnaire | Using Walking Ability Questionnaire to evaluate community ambulation ability. | Baseline, 4 weeks after training, and 4-week follow-up |
| Community Walking Speed | Using a timer to measure average walking speed in the community | 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 | Baseline, 4 weeks after training, and 4-week follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| Functional Gait Assessment | Using Functional gait assessment to evaluate walking performance | Baseline, 4 weeks after training, and 4-week follow-up |
| Six-minute Walk Test | Using Six-minute Walk Test to evaluate walking endurance |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yea-Ru Yang, PhD | Contact | +886228267279 | yryang@nycu.edu.tw |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University | Taipei | 112 | Taiwan |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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|
| Conventional physical therapy | Other | Strength, posture, gait, and functional training. |
|
| 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 | 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 | Baseline, 4 weeks after training, and 4-week follow-up |
| Tinetti Performance-Oriented Mobility Assessment | 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 | 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 | Baseline, 4 weeks after training, and 4-week follow-up |
| Stroke Impact Scale | Using Stroke Impact Scale to evaluate quality of life | Baseline, 4 weeks after training, and 4-week follow-up |
| Gait performance | Using GAITRite system to measure the gait spatiotemporal parameters | Baseline, post-intervention, 4 weeks after training, and 4-week follow-up |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |