Optimal Reactive Balance Training Characteristics Poststroke: Secondary Analysis of a Clinical Trial.
Júlia O Faria, Cynthia J Danells, Elizabeth L Inness and 1 others
More balance perturbations during training was associated with better reactive balance scores in 30 people with chronic stroke.
No training characteristic predicted fewer falls in daily life. The association is correlational, not causal.
Key findings
1For each additional 100 perturbations completed during training, the reactive balance sub-score of the mini-BEST improved by 0.48 points (p = 0.010).
2Task difficulty level, task type, perceived challenge, and success rate showed no significant association with post-intervention reactive balance scores.
3No training characteristic was significantly associated with falls in daily life.
Still to come
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Correlational design: the authors cannot rule out that people who completed more perturbations were simply more motivated, less fatigued, or had other unmeasured differences that also drove their balance gains. Sample of 30 with six regression models per outcome and no correction for multiple comparisons; the single significant result may be a false positive. Only baseline and post-training assessments were available; no intermediate measures to track the learning curve. All participants were in the chronic phase (mean 3.3 years post-stroke), so the finding may not apply to people in earlier recovery. Data came from a single site (Toronto Rehabilitation Institute); the original RCT had participants at other sites who were excluded here. The intervention was delivered in a research lab with a safety gantry and two experienced physiotherapists, which may not reflect typical community or inpatient settings.
Declared interests
Funded by the Canadian Institutes of Health Research (MOP 133577). The authors declare no conflicts of interest.
The easy way to misread this
Do not read the 0.48-point gain per 100 perturbations as proof that more training causes better balance. The design is correlational, the sample is 30 people from one site, and this was the only significant result across 12 models tested without correction for multiple comparisons. The authors themselves state that causality cannot be inferred and that the finding needs confirmation in a randomised trial.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →