Investigation the Effect of Reactive and Proactive Exercises on Balance Performance and Balance Confidence in Stroke Patients: A Randomized Clinical Trial

Abstract

Background: Stroke is the leading cause of disability in adults. The most prevalent disorder following a stroke is a balance disorder, and the primary goal of rehabilitation treatment in these patients is to improve balance. Objectives: This study aims to compare the effects of various balance therapy exercises on balance performance and balance confidence in individuals with stroke. Methods: In this double-blind clinical trial, 30 individuals with stroke were randomly assigned to one of three groups: Control, reactive, and proactive. Of these, 27 patients completed the study. Participants underwent 12 treatment sessions over four weeks. The control group received conventional exercises, the reactive group received conventional exercises plus reactive exercises, and the proactive group received conventional exercises plus proactive exercises. Balance performance was evaluated using the Mini-BESTest and the activities-specific balance confidence (ABC) questionnaire at three stages: Before treatment, after treatment, and during a two-month follow-up period. Data analysis was conducted using SPSS version 20. Results: Intra-group analysis indicated significant improvements in balance (F = 64.694; P < 0.001; ηp2 = 0.729) and balance confidence (F = 76.002; P < 0.001; ηp2 = 0.760). At the end of the treatment, the proactive group exhibited better balance performance compared to the reactive group, while the reactive group demonstrated higher balance confidence than the proactive group. However, these differences were not statistically significant (P > 0.05). Conclusions: Balance performance and balance confidence improved significantly in all three treatment groups. However, the differences between the groups were not statistically significant. This study concludes that exercise therapy is an integral component of rehabilitation treatment for stroke patients.