Comparison of Body Weight Support–Assisted Balance and Gait Training With or Without Balance Perturbations in Poststroke Rehabilitation: Multisite Randomized Controlled Trial
Bibliographic record
Abstract
Background: Impaired balance regulation after stroke puts patients and therapists at a heightened risk of injury during rehabilitation. Body weight support systems (BWSS) allow patients to safely conduct gait and balance training while minimizing risk and the fear of falling. Integrating perturbation-based balance training (PBT) modules with a BWSS may lead to further improvements. Objective: This study aimed to evaluate the impact of a ceiling-track-mounted BWSS plus an integrated PBT (BWSS-P) module on the rehabilitation of stroke-related gait and balance impairments. Methods: A multisite randomized active-comparator controlled trial was conducted. Inpatients with Berg Balance Scale (BBS) scores ≥21/56 were recruited from 4 sites. Participants completed 2-to-6 BWSS or BWSS-P study sessions. Both groups conducted the same balance and gait regimen, with the BWSS-P group also receiving 8 balance perturbations per session. BBS, Activities-Specific Balance Confidence, and 10 Meter Walk Test assessments were collected. Results: A total of 126 patients were approached with 99 yielding sufficient data for analysis. With a corrected α level of .0054, both groups showed significant in-group changes over time for all outcomes evaluated (P≤.001). However, the primary outcome measure, the BBS, did not show evidence of a difference between BWSS and BWSS-P groups over time (F1,97=1.57; P=0.21) via linear mixed effects modeling with type III Wald F test with Kenward-Roger degrees of freedom. No significant between-group differences were noted for either secondary outcome measure, the Activities-Specific Balance Confidence scale (F1,94.99=0.36; P=.55), or 10 Meter Walk Test (F1,97=4.15; P=.04). Conclusions: Although significant between-group differences were not observed, participants in both groups demonstrated similar improvements from before to after assessment. This novel PBT technology shows promise as an option for gait and balance recovery training, especially for individuals with impaired balance control or fear of falling. The BWSS-P intervention contributed positively to rehabilitation outcome overall and should be considered as a viable treatment modality when clinically appropriate.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.006 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.005 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".