Trial reportJournal of neuroengineering and rehabilitation2020
Intense and unpredictable perturbations during gait training improve dynamic balance abilities in chronic hemiparetic individuals: a randomized controlled pilot trial.
Trial report in Journal of neuroengineering and rehabilitation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Unpredictable Perturbations During Gait to Improve Balance Performance, Confidence and Participation in Persons With Hemiparesis at a Chronic Stage: a Pilot Study
Unblinded Quasi-Randomized Pilot Study Exploring the Benefits of the ZeroG TRiP System to Improve Patient Balance Following an Acute Stroke
Clinical Study of a Novel, Body-weight Supported, Balance-perturbation Module During the Rehabilitation of Gait and Balance Impairments Secondary to Stroke: A Multisite Randomized Control Trial
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Influence of Reactive Balance Training Program Characteristics on Reactive Balance Control and Fall Risk: A Systematic Review and Meta-Regression.Gerontology · 2026Pooled it
- Effects of Technology-Based Perturbation Training During Walking on Physical Function in Stroke, Multiple Sclerosis, and Parkinson's Disease: A Scoping Review.NeuroRehabilitation · 2026Article
- Proactive adjustments to cued gait perturbations in people with and without chronic stroke.Journal of neurophysiology · 2026Article
- Comparison of Body Weight Support-Assisted Balance and Gait Training With or Without Balance Perturbations in Poststroke Rehabilitation: Multisite Randomized Controlled Trial.JMIR rehabilitation and assistive technologies · 2025Article
- Proactive adjustments to cued gait perturbations in people with and without chronic stroke.bioRxiv : the preprint server for biology · 2025Article
- Stroke impairs the proactive control of dynamic balance during predictable treadmill accelerations.Journal of the Royal Society, Interface · 2025Article
- Assessment of Postural Control and Gait in Patients with Chronic Stroke After Treadmill Perturbation-Based Training: A Randomized Clinical Trial.Journal of clinical medicine · 2025Article
- Combined effects of Tai-Chi gait with mediolateral ground support perturbation on dynamic balance control.Sports medicine and health science · 2025Article
- Interventions to improve outdoor mobility among people living with disabilities: A systematic review.Campbell systematic reviews · 2024Review
- Design and Performance Analysis of a Mecanum-Built Perturbation-Based Balance Training Device.Applied bionics and biomechanics · 2024Article
- Evaluating the use of a balance prosthesis during balance perturbations in children and young adults with cochleovestibular dysfunction.Scientific reports · 2023Article
- A Cross-Sectional Study on Fall Direction and Lower Limb Loading in Response to a Perturbation on Laterally Inclined Platform.Applied bionics and biomechanics · 2023Article
- Feasibility of challenging treadmill speed-dependent gait and perturbation-induced balance training in chronic stroke patients with low ambulation ability: a randomized controlled trial.Frontiers in neurology · 2023Article
- Rehabilitation Supported by Technology: Protocol for an International Cocreation and User Experience Study.JMIR research protocols · 2022Article
- A Novel Body Weight-Supported Postural Perturbation Module for Gait and Balance Rehabilitation After Stroke: Preliminary Evaluation Study.JMIR rehabilitation and assistive technologies · 2022Article
- Perturbation-based balance training: Principles, mechanisms and implementation in clinical practice.Frontiers in sports and active living · 2022Review
- The Effectiveness of Perturbation-Based Training in the Treatment of Patients With Stroke: A Systematic Review and Meta-Analysis.Neuroscience insights · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious studies have assessed the effects of perturbation training on balance after stroke. However, the perturbations were either applied while standing or were small in amplitude during gait, which is not representative of the most common fall conditions. The perturbations were also combined with other challenges such as progressive increases in treadmill speed.
objectiveTo determine the benefit of treadmill training with intense and unpredictable perturbations compared to treadmill walking-only training for dynamic balance and gait post-stroke.
methodsTwenty-one individuals post-stroke with reduced dynamic balance abilities, with or without a history of fall and ability to walk on a treadmill without external support or a walking aid for at least 1 min were allocated to either an unpredictable gait perturbation (Perturb) group or a walking-only (NonPerturb) group through covariate adaptive randomization. Nine training sessions were conducted over 3 weeks. NonPerturb participants only walked on the treadmill but were offered perturbation training after the control intervention. Pre- and post-training evaluations included balance and gait abilities, maximal knee strength, balance confidence and community integration. Six-week phone follow-ups were conducted for balance confidence and community integration. Satisfaction with perturbation training was also assessed.
resultsWith no baseline differences between groups (p > 0.075), perturbation training yielded large improvements in most variables in the Perturb (p < 0.05, Effect Size: ES > .46) group (n = 10) and the NonPerturb (p ≤ .089, ES > .45) group (n = 7 post-crossing), except for maximal strength (p > .23) in the NonPerturb group. Walking-only training in the NonPerturb group (n = 8, pre-crossing) mostly had no effect (p > .292, ES < .26), except on balance confidence (p = .063, ES = .46). The effects of the gait training were still present on balance confidence and community integration at follow-up. Satisfaction with the training program was high.
conclusionIntense and unpredictable gait perturbations have the potential to be an efficient component of training to improve balance abilities and community integration in individuals with chronic stroke. Retrospective registration: ClinicalTrials.gov. March 18th, 2020. Identifier: NCT04314830.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.