The Effect of Frontal-plane Balance Training on Fall Prevention in Chronic Stroke Survivors: A Randomized Controlled Trial.

Introduction: This study investigated the impact of frontal plane-focused balance training (FPBT) on fall prevention in stroke survivors. Methods: A total of 59 chronic stroke survivors (mean age: 52.24±16.35 y, 18 female) were divided into the FPBT and control groups; both underwent an 8-week training program with three 1-hour sessions per week, incorporating single- and dual-task balance exercises. Primary outcomes included fall numbers and faller odds, while secondary outcomes assessed balance function using the Berg balance scale (BBS), mini-balance evaluation systems test (Mini-BEST), activities-specific balance confidence scale (ABC), and fall risk for older people in the community (FROP-Com). Results: No statistically significant differences were found in fall numbers or faller odds between the groups during the training (P=0.768 and P=0.065) or follow-up period (P=0.461 and P=0.298), using negative binomial and logistic regression, respectively. A decline in fall risk was observed in the FPBT group compared with the control group. Both groups showed significant improvements in secondary outcomes (BBS, P=0.013; Mini-BEST, P<0.001; ABC, P<0.001; and FROP-Com, P<0.001), with no significant between-group differences (BBS, P=0.395; Mini-BEST, P=0.295; ABC, P=0.186; and FROP-Com, P=0.886). Conclusion: The findings suggest that while FPBT did not significantly outperform conventional balance training in reducing falls, a trend toward fall risk reduction was observed. Further research is needed to optimize FPBT's effectiveness for stroke survivors. Highlights: FPBT showed consistent, though non-significant, reductions in fall numbers and faller odds compared to control across all periods, suggesting its potential as a promising intervention.All participants improved significantly in balance, mobility confidence, and fall risk measures after the intervention.No additional benefit of FPBT over control was found for any clinical outcome measure.Time effect dominated group effect, suggesting general benefits of any balance training. Plain Language Summary: This study tested whether a special type of balance training-focused on side-to-side (lateral) movements-could help prevent falls in people who have had a stroke. Falls are a major concern for stroke survivors, often leading to injuries and reduced independence. The researchers compared this new training, called frontal-plane balance training (FPBT), with traditional balance exercises to see which worked better. Fifty-nine stroke survivors were split into two groups: one did FPBT (practicing sideways balance exercises), while the other did standard balance training. Both groups exercised the practice three times a week for 8 weeks. The researchers tracked falls before, during, and 6 months after the training. They also measured balance, balance confidence, and fall risk using clinical tests. Both groups improved in balance and confidence, but FPBT did not differ significantly from traditional training. PBT showed a trend toward reducing falls: participants had fewer falls during and after training compared to the control group, but the difference was not large enough to be certain. No major differences were seen in balance test scores between the two groups, suggesting both methods helped similarly. Falls after a stroke can be life-changing, causing fractures or loss of independence. While FPBT did not outperform standard training, the trend suggests it might still be helpful. The study also confirms that any balance training can improve stability and balance confidence for stroke survivors. Future research could examine whether longer or more intensive FPBT programs make a greater difference.