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.

Study Overview

• Status: Not yet recruiting
• Conditions: Stroke
• Intervention / Treatment: Other: Vestibular training; Other: Conventional physical therapy

• Study Type: Interventional
• Enrollment (Estimated): 40
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Yea-Ru Yang, PhD; Phone Number: +886228267279; Email: yryang@nycu.edu.tw

Study Locations

• Taiwan
  • Taipei, Taiwan, 112
    • Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University
    • Contact: Yea-Ru Yang, PhD; Phone Number: +886-2-2826-7279; Email: yryang@nycu.edu.tw

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Vestibular training group; The intervention is a 40-minute session and 3 sessions/week, totaling 4 weeks.	Other: Vestibular training; Gaze stabilization exercises and balance training under visual and head-movement challenges to stimulate vestibular input and maintain balance.; Other Names: gaze stabilization exercises; vestibular rehabilitation
Active Comparator: Conventional physical therapy Group; The intervention is a 40-minute session and 3 sessions/week, totaling 4 weeks.	Other: Conventional physical therapy; Strength, posture, gait, and functional training.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	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

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Gait performance	Using GAITRite system to measure the gait spatiotemporal parameters	Baseline, post-intervention, 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
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	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
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

Collaborators and Investigators

• Sponsor: National Yang Ming Chiao Tung University

Study record dates

Study Major Dates

• Study Start (Estimated): April 1, 2026
• Primary Completion (Estimated): July 31, 2028
• Study Completion (Estimated): July 31, 2028

Study Registration Dates

• First Submitted: March 20, 2026
• First Submitted That Met QC Criteria: March 20, 2026
• First Posted (Actual): March 27, 2026

Study Record Updates

• Last Update Posted (Actual): March 27, 2026
• Last Update Submitted That Met QC Criteria: March 20, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: stroke; gait; community ambulation; fall risk; vestibular rehabilitation; vestibular training; dynamic acuity
• Additional Relevant MeSH Terms: Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Stroke
• Other Study ID Numbers: NYCU114245AF2

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No