Usefulness of one-arm motorized gait device for chronic hemiplegic stroke survivors.

BACKGROUND: After stroke, gait training is a key component of rehabilitation, and most individuals use a variety of walking aids depending on their physical condition and environment. OBJECTIVE: This study aimed to investigate the potential effect of a one-arm motorized gait device for gait assist of chronic hemiplegic stroke survivors through comparison with traditional gait devices (parallel bar and hemi-walker). METHODS: This study was conducted on 14 chronic hemiplegic stroke survivors. The participants were asked to walk under three conditions using different gait devices, and their gait parameters during walking were collected and analyzed. The first condition involved walking on parallel bars; second condition, walking using hemi-walkers; and third condition, walking using one-arm motorized gait devices. With the use of a gait analysis system, the spatio-temporal gait parameters in each condition were collected, such as gait velocity, cadence, step length, stride length, single support time, and double support time. RESULTS: In the results by repeated-measures ANOVA or the Friedman test, a significant difference was found in the gait parameters among all three conditions (p< 0.05). The post-hoc test showed a significant change in the spatio-temporal gait parameters (especially, velocity, cadence and affected side single and double support time) when one-arm motorized gait device were used compared with parallel bars and hemi-walkers (p< 0.05). CONCLUSION: The results of this study suggest that one-arm motorized gait devices developed for hemiplegic stroke survivors may be more effective potentially than parallel bars and hemi-walkers in gait assistance of chronic hemiplegic stroke survivors.

Upper-Limb Robot-Assisted Therapy Based on Visual Error Augmentation in Virtual Reality for Motor Recovery and Kinematics after Chronic Hemiparetic Stroke: A Feasibility Study.

The purpose of this study was to investigate the effect of upper-limb robot-assisted therapy based on visual error augmentation in virtual reality (UL-RAT-VEAVR) for motor recovery and kinematics after chronic hemiparetic stroke. This study applied a single-group pre- and post-intervention study design. A total of 27 stroke survivors (20 males and 7 females; mean age 54.51 years, mean onset duration 12.7 months) volunteered to participate in this study. UL-RAT-VEAVR was performed three times a week for four weeks, amounting to a total of twelve sessions, in which an end-effector-based robotic arm was used with a visual display environment in virtual reality. Each subject performed a total of 480 point-to-point movements toward 3 direction targets (medial, ipsilateral, and contralateral side) in the visual display environment system while holding the handle of the end-effector-based robotic arm. The visual error (distance to the targets on the monitor) in virtual reality was increased by 5% every week based on the subject's maximum point-to-point reaching trajectory. Upper-limb motor recovery was measured in all subjects using the Fugl−Meyer Assessment (FMA) upper-limb subscale, the Box and Block Test (BBT), and the Action Research Arm Test (ARAT), before and after training. In addition, a kinematic assessment was also performed before and after training and consisted of time, speed, distance, and curvilinear ratio for point-to-point movement. There were significant improvements in both upper-limb motor function and kinematics after 4 weeks of UL-RAT-VEAVR (p < 0.05). Our results showed that the UL-RAT-VEAVR may have the potential to be used as one of the upper-limb rehabilitation strategies in chronic stroke survivors. Future studies should investigate the clinical effects of the error-augmentation paradigm using an RCT design.

Feasibility of training using full immersion virtual reality video game in young stroke survivor: A case report.

BACKGROUND: With the recent developments in science, full-immersion virtual reality devices have been developed, which may have feasibility for stroke rehabilitation. OBJECTIVE: This case report investigated the feasibility of training using a full-immersion virtual reality video game for improving motor function, balance, and gait in a young stroke survivor. METHOD: The case was a 27-year-old woman with stroke. A training using full-immersion virtual reality video game (Sony PlayStation®VR) was performed for 30 minutes per session, 3 sessions per week, for 6 weeks, with a total of 18 sessions. Before training and at each training for 6 weeks, with a total of 19 times, the motor function, balance, and gait were assessed using the Motor Assessment Scale (MAS), Berg Balance Scale (BBS), Timed Up and Go (TUG) Test, and Tinetti Balance Assessment, 10 Meter Walk Test (10MWT), Tinetti Gait Assessment, and Dynamic Gait Index (DGI). RESULTS: During the training, there were no adverse events reported. The case achieved 14 points higher than the pre-assessment with 34 points on the MAS, 16 points higher than the pre-assessment with 48 points on BBS, 6.85 sec lower than the pre-assessment, with 13.58 sec on TUG, 5 points higher than the pre-assessment with 13 points on the Tinetti Balance Assessment, 5.36 sec lower than the pre-assessment, with 8.15 sec on the 10MWT, 4 points higher than the pre-assessment with 10 points on the Tinetti Gait Assessment, and 10 points higher than the pre-assessment with 21 points on the DGI. CONCLUSION: This case report suggests that training using a full-immersion virtual reality video game may be a safe and effective method to improve motor function, balance, and gait in a young stroke survivor.

Effects of two different robot-assisted arm training on upper limb motor function and kinematics in chronic stroke survivors: A randomized controlled trial.

BACKGROUND: Comparative studies of different robotic types are warranted to tailor robot-assisted upper limb training to patient's functional level. OBJECTIVES: This study aimed to directly compare the effects of high inertia robot arm (whole arm manipulator, WAM) and low inertia robot arm (Proficio) on upper limb motor function in chronic stroke patients. METHODS: In this randomized controlled trial, 40 chronic stroke survivors were randomized into robot-assisted arm training with WAM (RAT-WAM) and robot-assisted arm training with Proficio (RAT-P) groups. The RAT-WAM and RAT-P groups participated in the robot-assisted arm training with WAM and robot-assisted arm training with Proficio, respectively, for 40 min daily, three times weekly over a four week. Upper limb motor function was measured before and after the intervention using the Fugl-Meyer assessment (FMA), action research arm test, and box and block test (BBT). Curvilinearity ratio (the length ratio of a straight line from the start to the target) was also measured as an index for upper limb kinematic performance. RESULTS: The RAT-WAM and RAT-P groups showed significant improvements in FMA-total and -proximal (shoulder/elbow units), BBT, and ARAT after the intervention (P < .05). Also, the RAT-P group showed significantly more improvement than the RAT-WAM group in FMA-distal (hand/wrist units) (P < .05). CONCLUSIONS: Improvements of upper limb motor function occurred during robot-assisted arm training with robotic systems. Low inertia robot arm was more effective in improving the motor function of the hand and wrist. The results may be useful for robot-assisted training for upper limb impairment.

Gait analysis in hemiplegic stroke survivors who used the one-arm motorized walker.

OBJECTIVE: A high number of stroke survivors experience limitations in balance and gait abilities. Thus, an improvement in gait ability is an important goal in the rehabilitation of hemiplegic stroke survivors. This study aimed to investigate the effect of using the one-arm motorized walker, a hemi-walker developed to assist hemiplegic stroke survivors in gait training and activities of daily living, on the improvement in gait ability in hemiplegic stroke survivors. METHODS: Eleven hemiplegic stroke survivors who met the inclusion criteria were included. The participants were instructed to walk thrice using traditional walking aids on a gait mat and then to walk thrice using the one-arm motorized walker. During each walk, spatiotemporal gait parameters, including velocity, cadence, step length, stride length, single support time, and double support time, were evaluated using a gait analysis system. RESULTS: Velocity and cadence significantly increased when the participants walked using the one-arm motorized walker compared to those who used traditional walking aids (p< 0.05), whereas double support time significantly decreased for both the more affected and less affected sides (p< 0.05). However, no significant difference was observed in terms of step length and single support time. CONCLUSION: The one-arm motorized walker may have a positive effect on the improvement of gait ability in hemiplegic stroke survivors. It can be an effective walking aid for hemiplegic stroke survivors who experience difficulties in independent walking.

A novel one arm motorized walker for hemiplegic stroke survivors: a feasibility study.

BACKGROUND: A hemiplegic stroke survivor with a moderate to severe gait disturbance may have difficulty walking using a one-arm walker. This study aimed to test the safety and feasibility of a prototype one-arm motorized walker that uses a power-driven device to provide gait assistance to hemiplegic stroke survivors with moderate to severe gait disturbances. METHODS: A one-arm motorized walker with a power-driven device was developed and tested with respect to 10 distinct variables, including weight, degrees of freedom, handle, handle substitution function, two-sided use function, variable handle height, redirecting function, electric moving parts through the handle control, brake function using the handle control, folding chairs, and design stability. Its safety and feasibility were tested in 19 hemiplegic stroke individuals using the Likert scale and a simple interview. RESULTS: The walker consists of a frame platform including a handle, electric motor for driving, one wheel for driving, two wheels for turning, unlocking sensor, driving button, and turning buttons. The walker is programmed so that a touch sensor in the handle can unlock the locking system. Furthermore, it is programmed so that a user can propel it by pushing the handle downward or pressing a button and can control directions for turning right or left by pressing buttons. Safety and performance testing was achieved for 10 separate variables, and a Likert scale score of 3.5 of 5 was recorded. CONCLUSION: This walker's novel design was developed for hemiplegic stroke survivors with moderate to severe gait disturbances. Our findings indicate that the walker is both safe and feasible for providing walking assistance to hemiplegic stroke survivors and establish the potential advantages of the one-arm motorized walker.

Is robot-assisted therapy effective in upper extremity recovery in early stage stroke? -a systematic literature review.

[Purpose] The aim of this study was to systematically investigate the effects of robot-assisted therapy on the upper extremity in acute and subacute stroke patients. [Subjects and Methods] The papers retrieved were evaluated based on the following inclusion criteria: 1) design: randomized controlled trials; 2) population: stroke patients 3) intervention: robot-assisted therapy; and 4) year of publication: May 2012 to April 2016. Databased searched were: EMBASE, PubMed and COCHRAN databases. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the included studies. [Results] Of the 637 articles searched, six studies were included in this systematic review. The PEDro scores range from 7 to 9 points. [Conclusion] This review confirmed that the robot-assisted therapy with three-dimensional movement and a high degree of freedom had positive effects on the recovery of upper extremity motor function in patients with early-stage stroke. We think that the robot-assisted therapy could be used to improve upper extremity function for early stage stroke patients in clinical setting.

Effects of expiratory muscle strength training on swallowing function in acute stroke patients with dysphagia.

[Purpose] This study was conducted to identify the effects of expiratory muscle strength training on swallowing function in acute stroke patients with dysphagia. [Subjects and Methods] A total of 18 stroke patients with dysphagia were enrolled in the study. All participants were randomly assigned to either an experimental group (n=9) or a control group (n=9). All participants performed traditional-swallowing rehabilitation therapy in 30-minute sessions five times a week for four weeks; however, only the experimental group received expiratory muscle strength training. [Results] Both groups showed significant improvements after mediation. When compared with the control group, the functional dysphagia scale, vallecular residue, and penetration-aspiration scale were significantly improved in the experimental group. [Conclusion] Expiratory muscle strength training is an effective intervention for impaired swallowing function in acute strike patients with dysphagia.

Discriminative and predictive validity of the short-form activities-specific balance confidence scale for predicting fall of stroke survivors.

[Purpose] The present study aimed to investigate the discriminative validity of the short-form activities-specific balance confidence scale (ABC scale) in predicting falls, and its validity. [Subjects and Methods] 43 stroke survivors were identified as a group with a history of multiple falls (faller group) and a group without or with a history of one falls (non-faller group). The balance confidence was examined using the ABC scale and the short-form ABC scale. Functional abilities were examined with Fugl-Meyer assessment, sit-to-stand test, and Berg balance scale. [Results] The area under the curve of the ABC scale and the short-form ABC scale in predicting fall was>0.77. This result indicates that both examination tools have discriminative validity in predicting falls. Although both tools showed an identical predictable specificity of 72% in the non-faller and faller groups, the short-form ABC scale exhibited a predictable sensitivity of 86% in the faller group, which is higher than that of the ABC scale (71%). [Conclusion] Results of this study showed that the short-form ABC scale is an efficient clinical tool to evaluate and predict the balance confidence of stroke survivors.

Comparison of trunk electromyographic muscle activity depends on sitting postures.

BACKGROUND: Different postural positions can be characterized by the activation and relative contributions of different postural muscles, and may variously contribute to the recovery from or worsening of chronic lower back pain. OBJECTIVE: The present study aimed to investigates trunk muscle activities in four types of seated postures: cross-legged, long, side, and W-shaped. METHODS: Eight healthy adults participated in the study. Trunk muscle activities of the external oblique (EO), rectus abdominis (RA), latissimus dorsi (LD), and erector spinae (ES) muscles in each of the sitting postures including cross-legged, long, side, and W-shaped were collected utilizing surface electromyography (sEMG). The mean sEMG signals in each of the sitting postures were used for statistical comparisons. RESULTS: There were no significant differences in electromyographic muscle activity of EO, RA, LD, and ES in the four postures (p > 0.05). However, in the W-shape sitting posture, the left LD showed the greatest electromyographic muscle activity, followed by the right LD and left EO, respectively. The right and left LD in the long sitting posture and left ES in the side sitting posture showed greater electromyographic muscle activity than that of other muscles. CONCLUSION: Based on the results, trunk muscle activity did not significantly differ between the four types of sitting postures. However, our study is limited by its experimental method and sample size. Thus, in the Future, further study will be needed.

Risk factors associated with musculoskeletal symptoms in Korean dental practitioners.

[Purpose] The purpose of this study was to investigate the association between psychosocial stress, occupational stress, and musculoskeletal symptoms in Korean dental practitioners. [Subjects and Methods] Self-reported questionnaires were distributed to 401 dental practitioners in Korea. To assess the risk factors related to musculoskeletal disorders, the Nordic Musculoskeletal Questionnaire, the Korean Occupational Stress Scale, and Psychosocial Well-Being Index Short Form were used. General and work-related characteristics of the subjects consisted of seven items, including age, career, height, weight, working days/week, working hours/day, and physical strain levels. [Results] In this study, 86.8% of the practitioners experienced musculoskeletal symptoms (shoulders, 72.8%; neck, 69.3%; waist, 68.3%; wrist, 58.4%; back, 44.1%; ankle, 38.7%; knee, 36.9%; hip, 20.4%; and elbows, 9.2%). Moreover, psychosocial and occupational stress can affect the occurrence of musculoskeletal disorders. In particular, we found that psychosocial stress has significant influence on the occurrence of musculoskeletal disorders. [Conclusion] To increase the quality of life and provide high-quality medical service for dental practitioners, risk factors for musculoskeletal disorders must be managed. Accordingly, dental practitioners must maintain good posture, get an appropriate amount of rest, and perform regular stretching exercise to reduce psychological stress and improve the work environment.

Risk factors related to falling in stroke patients: a cross-sectional study.

[Purpose] The purpose of this study was to investigate a comprehensive understanding of the factors associated with falls in poststroke patients. [Subjects] Forty-eight stroke patients (22 males and 26 females; age 63.79 years) participated in this study. [Methods] This study applied a cross-sectional design. Fear of falling [Falls Efficacy Scale (FES)], balance function [Berg Balance Scale (BBS) and Modified Rivermead Mobility Index (MRMI)], ADL performance level [Modified Barthel Index (MBI)] and cognitive function [Loewenstein Occupational Therapy Cognitive Assessment for Geriatric Populations (LOTCA-G)] were assessed. [Results] Falls efficacy was moderately correlated with ADL performance, balance, and cognition. In addition, stepwise linear regression analysis revealed that ADL performance was the explanatory variable closely associated with falls efficacy in stroke patients. [Conclusion] ADL performance was the primary explanatory variable of falls efficacy according to regression analysis. Thus, we suggest that these results may be used as basic data for developing rehabilitation programs for prevention of falls in stroke patients.

Influence of transcutaneous electrical nerve stimulation on weight distribution in lower leg muscles.

[Purpose] The purpose of this study was to compare the effects of transcutaneous electrical nerve stimulation (TENS), with and without visual input, on weight distribution following exercise-induced fatigue in the dorsiflexor and plantar flexor muscles of the ankle. [Subjects and Methods] This study had a cross-sectional design. Nineteen healthy adults (10 males, 9 females; mean age 21±0.8 years) were recruited to participate in a single group repeated measurements study lasting three days. On the first day, following exercise-induced fatigue, the standing position was maintained for 30 minutes, after which the postural sway was measured with eyes open (EO) and eyes closed (EC). On the second day, TENS was applied to the ankle dorsiflexors in the standing position for 30 minutes following exercise-induced fatigue. On the last day, TENS was applied to the plantar flexors, and the postural sway was measured with EO and EC following the same exercise-induced fatigue. [Results] On level terrain, with and without visual input, there was a significant difference between the baseline values and those following TENS on the tibialis anterior. On uneven terrain (simulated by a cushion), with and without visual input, there was a significant difference between the baseline values and those following TENS on the gastrocnemius. [Conclusion] Clinically, during walking on a flat surface for only a short period of time, TENS should be applied to the tibialis anterior. If walking training is performed on a variety of terrains for a longer time, TENS should be applied to the gastrocnemius.

Relationship between Postural Sway and Dynamic Balance in Stroke Patients.

[Purpose] The purpose of the current study was to investigate the relationship between postural sway and dynamic balance in post stroke patients. [Subjects] Thirty-one stroke patients (20 men and 11 women; age 64.25 years; stroke duration 12.70 months; MMSE-K score 26.35) participated in this study. [Methods] This study applied a cross-sectional design. A Good Balance system was used for measurement of the postural sway velocity (anteroposterior and mediolateral) and velocity moment of subjects under the eyes open and eyes closed conditions in a standing posture. The postural sway of subjects was measured under two surface conditions (stable and unstable surfaces). [Results] On the unstable surface (foam), no significant correlation was observed between postural sway and dynamic balance except for the berg balance scale (BBS) score and anteroposterior postural sway velocity under the eyes open condition, anteroposterior postural sway velocity under the eyes closed condition, and postural sway velocity moment. In addition, in the stable condition, no significant correlation was observed between postural sway and dynamic balance. [Conclusion] Our results indicate that a decrease in postural sway does not necessarily reflect improvement of dynamic balance ability. We believe that this finding may be useful in balance rehabilitation for prevention of falls after a stroke.

Community walking training program improves walking function and social participation in chronic stroke patients.

Stroke patients live with balance and walking dysfunction. Walking is the most important factor for independent community activities. The purpose of this study was to investigate the effect of a community walking training program (CWTP) within the real environment on walking function and social participation in chronic stroke patients. Twenty-two stroke patients (13 male, 50.45 years old, post stroke duration 231.64 days) were randomly assigned to either the CWTP group or the control group. All subjects participated in the same standard rehabilitation program consisting of physical and occupational therapy for 60 min per day, five times a week, for four weeks. In addition, the CWTP group participated in CWTP for 30 min per day, five times a week, for four weeks. Walking function was assessed using the 10-m walk test (measurement for 10-meter walking speed), 6-min walk assessment (measurement of gait length for 6-minutes), and community gait assessment. Social participation was assessed using a social participation domain of stroke impact scale. In walking function, greater improvement was observed in the CWTP group compared with the control group (P < 0.05). In addition, social participation improved more in the CWTP group compared with the control group (P < 0.05). These findings demonstrate the efficacy of CWTP on walking function and social participation in chronic stroke patients. Therefore, we suggest that CWTP within the real environment may be an effective method for improving walking function and social participation of chronic stroke patients when added to standard rehabilitation.

Changes in postural sway according to footwear types of hemiparetic stroke patients.

[Purpose] The purpose of the current study was to investigate the influence of footwear type on postural sway of hemiparetic stroke patients. [Subjects] Thirty-two stroke patients who were undergoing a rehabilitation program were recruited on a voluntary basis from local rehabilitation unit. [Methods] This study had a single-group repeated-measures design. The Good Balance system was used to measure the postural sway velocity (anteroposterior and mediolateral) and velocity moment of the subjects under the eyes open and eyes closed conditions in the standing posture. Postural sway of the subjects in four types of footwear was measured, including barefoot, high heel-collar shoes, flat shoes, or slippers. [Results] The postural sway when wearing the flat shoes or slippers was significantly higher than that when barefoot or wearing high heel-collar shoes. In addition, postural sway velocity and velocity moment of all the footwear types were significantly higher under the eyes closed condition than under the eyes open condition. [Conclusion] Our results reveal that when the subjects wore flat shoes or slippers they had more difficulty than when they wore the high heel-collar shoes in postural control when maintaining standing balance. We believe that this result provides basic information for improvements in postural control and may be useful in balance training to prevent falls after stroke.

Reliability of the good balance system(®) for postural sway measurement in poststroke patients.

[Purpose] The purpose of this study was to examine test-retest reliability of the Good Balance system(®) for measurement of postural sway in poststroke patients. [Subjects] Sixty chronic stroke patients (40 men and 20 women; age 63.08 years; stroke duration 16.45 months) participated in this study. [Methods] Postural sway was evaluated using a force platform system (Good Balance system, Metitur Oy, Jyvaskyla, Finland). Two examiners measured postural sway for all participants during two separate testing sessions. The second measurement was performed one week after the first measurement. Intraclass correlation coefficients [ICC(2,1)] were used for estimation of reliability. [Results] The ICC (95% CI) for intra-examiner reliability was good to very good, ranging from 0.69 to 0.93 (0.53-0.96), and the ICC for inter-examiner reliability was good to very good, ranging from 0.85 to 0.98 (0.77-0.99). [Conclusion] The results of the current study indicated that the intra- and inter-examiner reliability of the Good Balance system(®) for measurement of postural sway was good to very good. Therefore, we suggest that measurement of postural sway using the Good Balance system(®) would be useful for clinical assessment in poststroke patients.

The effects of body weight support treadmill training with power-assisted functional electrical stimulation on functional movement and gait in stroke patients.

OBJECTIVE: The aim of the current study was to examine the effect of body weight support treadmill training (BWSTT) with power-assisted functional electrical stimulation on functional movement and gait in stroke patients. DESIGN: Thirty stroke patients were randomly assigned to either the experimental group (n = 15) or the control group (n = 15). All subjects participated in the same standard rehabilitation program. In addition, the experimental group participated in BWSTT with power-assisted functional electrical stimulation for 30 mins per day, five times a week, for 4 wks, and those in the control group participated in BWSTT for 30 minutes per day, five times a week, for 4 wks. Functional movement was assessed using the Berg Balance Scale, the Timed Up and Go test, and the Stroke Rehabilitation Assessment of Movement. Gait ability was assessed using an electrical walkway system. RESULTS: Significant differences in the time factor for functional movement and gait (P < 0.05) were observed in the experimental and control groups. For the group × time interaction, significant improvements were observed in the functional movement (Berg Balance Scale [10.93 vs. 6.00], Timed Up and Go test [-9.25 vs. -5.25 secs], and Stroke Rehabilitation Assessment of Movement scores [14.07 vs. 9.80]) and gait (velocity [40.07 vs. 18.64 cm/sec], cadence [30.57 vs. 17.75 steps per minute], paretic side step length [19.36 vs. 8.46 cm], and stride length [30.57 vs. 12.71 cm]) (P < 0.05). CONCLUSIONS: The findings of the current study demonstrated the efficacy of BWSTT with power-assisted functional electrical stimulation on the functional movement and gait ability in stroke patients. Therefore, the authors suggest that power-assisted functional electrical stimulation may be an effective method for the improvement of functional movement and gait ability of stroke patients when added to BWSTT.

Impaired dynamic balance is associated with falling in post-stroke patients.

Falling is one of the most common complications of stroke. The purpose of this study was to investigate the impact of falling on cognitive and physical function in post-stroke patients. Further, the predictive factors associated with independence of activity of daily living (ADL) in stroke patients with falls experience were investigated. Sixty-six participants were divided into 2 groups according to history of falling: faller (n = 34) and non-faller (n = 32). All participants were examined for cognitive and physical function. Static balance was measured by postural sway using a force platform. Dynamic balance was measured using the Berg Balance Scale (BBS) and the Modified Rivermead Mobility Index (MRMI), which shows the degree of performance for balance tasks. ADL was measured using the Modified Barthel Index (MBI), which shows the degree of independence. The fallers showed lower cognitive and physical function than the non-fallers (p < 0.05). This finding indicates that falling is associated with reduced physical function, as well as reduced cognitive function. In the fallers, the ADL (MBI) was moderately correlated with each of cognition [MMSE (r = 0.388, p = 0.023)], dynamic balance [MRMI (r = 0.514, p = 0.002) and BBS (r = 0.572, p < 0.000)]. In addition, regression analysis showed that BBS was a primary predictor for ADL performance (R(2) = 0.327, ß = 0.572, p < 0.000). Our findings indicate that enhancement of dynamic balance is needed to improve in activities necessary for normal self-care of stroke patients with falls experience.

Effect of a local vibration stimulus training programme on postural sway and gait in chronic stroke patients: a randomized controlled trial.

OBJECTIVE: To investigate the effect of a local vibration stimulus training programme on postural sway and gait in stroke patients. DESIGN: A randomized controlled trial with two groups: a local vibration stimulus training programme group and a sham group. SETTING: Inpatient rehabilitation centre. SUBJECTS: Thirty-one chronic stroke patients. INTERVENTIONS: Both groups underwent a standard rehabilitation programme. The local vibration stimulus training programme group (n = 16) participated in the local vibration stimulus training programme for 30 minutes a day, five times a week, for six weeks. The sham group (n = 15) participated in a sham local vibration stimulus training programme for 30 minutes a day, five times a week, for six weeks. MAIN MEASURES: A forceplate was used to measure postural sway under two conditions: standing with eyes open and eyes closed. Gait ability was measured using the GAITRite system. RESULTS: In postural sway, greater improvements in the postural sway distance with eyes-open (-11.91 vs. 0.80) and eyes-closed (-20.67 vs. -0.34) conditions and postural sway velocity with eyes-open (-0.40 vs. 0.03) and eyes-closed (-0.69 vs. -0.01) conditions were observed in the local vibration stimulus training programme group, compared with the sham group (P < 0.05). In gait ability, greater improvement in gait speed (15.06 vs. 2.85), cadence (8.46 vs. 1.55), step length (7.90 vs. 3.64), and single limb support time (0.12 vs. 0.01) were observed in the local vibration stimulus training programme group, compared with the sham group (P < 0.05). CONCLUSIONS: These findings suggest that local vibration stimulus training programme is an effective method for improvement of the postural sway and gait ability of chronic stroke patients.