Balance impairment limits ability to increase walking speed in individuals with chronic stroke.

This was a cross-sectional study, so it cannot show that balance impairment caused the inability to increase walking speed or that balance training would improve walking speed reserve. No formal power analysis was done; all eligible participants meeting criteria were included, so the sample may not represent all people with chronic stroke. Walking speed was measured by two methods depending on site, a 3 Meter Walk Test or a GAITRite mat, rather than one uniform protocol. The 0.2 m/s threshold for being unable to increase speed did not perfectly separate groups in this sample. Some participants with Berg Balance Scale scores as high as 56 were still unable to increase speed, so balance was not the only possible contributor. The analyses focused on balance and did not assess other possible factors such as strength, endurance, tone, or comorbidities like arthritis.

The authors reported no conflicts of interest.

Do not conclude that balance training will improve walking speed reserve. This study found an association at one time point; it did not test an intervention. Do not use a Berg Balance Scale score below 47 as proof that balance is the only cause of an inability to increase speed.