This randomized controlled trial will evaluate the effectiveness of sensory reweighting techniques on balance and risk of falls in individuals with chronic ischemic stroke. A total of 46 participants will be recruited using purposive sampling and randomly assigned into two groups through the sealed envelope method. Balance and fall risk will be assessed using the Berg Balance Scale and the Timed Up and Go test at baseline and after completion of the intervention. Participants in the experimental group will receive sensory reweighting-based balance training three times per week for eight weeks, incorporating altered sensory conditions such as reduced visual input, unstable surfaces, and vestibular challenges. The control group will receive conventional balance training of similar duration and intensity without sensory manipulation. Both groups will also receive standard physiotherapy throughout the intervention period. Ethical approval will be obtained prior to data collection, written informed consent will be secured from all participants, and confidentiality and voluntary participation will be ensured.
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Parallel
Sensory Reweighting Balance Training
BehavioralParticipants will receive sensory reweighting-based balance training aimed at improving postural control by enhancing the central nervous system's ability to integrate visual, vestibular, and somatosensory inputs. Training will be conducted three times per week for eight weeks, with 45-minute sessions including warm-up, core balance exercises, and cool-down. Exercises will be performed under altered sensory conditions, such as standing on foam surfaces, performing tasks with eyes closed, head movements during stance and gait, and dual-task activities. Task difficulty will be progressively increased based on individual tolerance while maintaining safety.
Conventional Balance Training
BehavioralParticipants will receive conventional balance training without sensory reweighting components. The program will be delivered three times per week for eight weeks, with each session lasting approximately 45 minutes. Exercises will focus on static and dynamic balance tasks such as standing with a narrow base, sit-to-stand practice, and forward/backward walking. No manipulation of sensory input will be included. Training intensity and duration will be matched to the experimental group to ensure comparability of outcomes.
Balance Performance
Balance will be measured using the Berg Balance Scale (BBS), a validated clinical tool consisting of 14 functional tasks assessing postural control, stability, and fall risk in chronic ischemic stroke patients. Each task is scored from 0 (unable to perform) to 4 (independent and safe), with a maximum total score of 56. Higher scores indicate better balance, and scores below 45 suggest increased risk of falls. Assessments will be conducted at baseline and after completion of the 8-week intervention to evaluate the efficacy of sensory reweighting balance training compared to conventional balance exercises.
Risk of Falls
Risk of falls will be evaluated using the Timed Up and Go (TUG) test, a standardized and widely used measure of functional mobility and dynamic balance in neurological populations. The test records the time (in seconds) required for a participant to stand up from a chair, walk 3 meters, turn around, walk back, and sit down. Shorter completion times indicate better mobility and lower fall risk, while times greater than 20 seconds suggest an increased risk of falls. The TUG test will be administered at baseline and after completion of the 8-week intervention to compare changes between the sensory reweighting training group and the conventional balance training group.
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Montiha Azeem
Lead sponsor
University of Lahore
Sponsor institution
