Vestibular Training on Community Ambulation and Fall Risk in Stroke

Effects of Vestibular Training on Community Ambulation and Fall Risk in Individuals With Chronic Stroke

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.

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