Project Overview

This project will determine the optimal intensity of reactive balance training (RBT) for people with chronic stroke. More specifically, we will find the intensity that improves balance in the shortest period of time. We suspect that high-intensity RBT may lead to quicker improvements compared to moderate-intensity RBT. We also think that both high and moderate-intensity RBT will be more effective than regular walking exercises in improving balance reactions. This research will help define clear guidelines for clinicians to make rehabilitation more effective for stroke survivors, reducing fall risk and enhancing quality of life.

63 men and women with chronic stroke will be randomly divided into three groups: a high-intensity RBT, moderate-intensity RBT, or a walking control group. The first phase will include baseline assessments where we will assess balance, fear of falling, and quality of life. We will determine the fastest platform speed at which participants can maintain their balance with a single step (multi-step threshold) without falling. Once baseline measures are taken, participants will do four consecutive days of one-hour training sessions supervised by a physiotherapist. To ensure safety, participants will be fitted to a harness while on the moving platform. The high-intensity group will have the moving platform moving 50% faster than their multi-step threshold speed, the moderate-intensity group will have the moving platform set to their multi-step threshold speed. In both RBT groups, they will feel 36 multi-directional movements that will cause them to fall forward, to the left, or to the right in a random order during each training session. The walking control group will walk on a stationary platform without the platform moving in any direction. We will monitor how well participants improve their balance one year after training.

Principal Investigator

Tawanda Majoni , University Health Network

Partners and Donors

Heart and Stroke Foundation