Effect of computerised targeted visual biofeedback exercises on balance in stroke patients

Maneesha S Deshpande, Sukhna Kaur Khurana, Pushpa Dhote


Stroke is an acute onset of neurological dysfunction due to an abnormality in cerebral circulation with resultant signs and symptoms that corresponds to involvements of the focal areas of brain. Stroke results into decreased proprioceptive sense and muscle strength which leads to impaired balance. Hence in this study, two visual biofeedback exercises were selected to find out the effect on balance in stroke patients. 26 subjects fulfilling the inclusion criteria were selected and divided into control (n=13) and experimental (n=13) groups. Pre intervention step test was measured. The exercise regime protocol was same for both the groups except the control group underwent visual biofeedback exercises in parallel bars in front of the mirror and the Experimental group underwent computerised targeted visual biofeedback exercises for 5 sessions/week for 4 weeks. Step test was reassessed at the end of 4th week. Data analysis was done by using paired and unpaired t-test where p value was <0.005. The results of the present study showed that there was no significant difference in the post step test values of experimental group when compared to the control group. Both the groups showed improvement in the post intervention step test scores. So, it can be concluded that both the visual biofeedback exercises were equally effective to improve the balance in stroke patients.


Keywords: Stroke, Balance, Step test, Biofeedback, Computerized Targeted exercises.

Full Text:



Deekshita B, Srikumari V, Madhavi K. Effect of task oriented exercises on standing balance in subjects with stroke. Int J Physiother 2014;1(5):242-7.

Kathlen Strong, Colin Mathers, Ruth Bonita. Preventing stroke: Saving lives around the world. Lancet Neurol 2007;6(2):182-7.

Baneerjee TK, Das SK. Epidemiology of stroke in India. Neurol Asia 2006;11:1-4.

Hesham Galal Mahran, Emad Tawfik Ahmed, Shamekh Mohammed El- Shamy, Amir Abdel-Raouf El- Fiky. Effect of balance training on postural control and risk of falls in stroke patients. Int J Adv Res 2017;5(1):316-25.

Eser F, Yavuzer G, Karakus D, Karaoglan B. The effect of balance training on motor recovery and ambulation after stroke: A randomized controlled trial. Eur J Phys Rehabil Med 2008;44:19-25.

Oliveira CB, Medeiros IT, Frota NF, Greters ME, Conforto AB. Balance control in hemiparetic stroke patients: Main tools for evaluation. J Rehabil Res Dev 2008;45(8):1215–26.

Min Jae Lee, Sun-Min Lee, Hyun-Mo Koo. The effect of virtual reality balance training program on balance ability and fall efficacy of stroke patients. Indian J Sci Technol 2016;9(S1):1-5.

Lin PY, Yang YR, Cheng SJ, Wang RY. The relation between ankle impairments and gait velocity and symmetry in people with stroke 2006. Arch Phys Med Rehabil 2006;87(4):562-8.

Hamed Ghomashchi. Effect of visual biofeedback therapy on postural balance of stroke patients. Phys Treat 2014;4(1):1-3.

Dault MC. Effects of visual centre of pressure feed- back on postural control in young and elderly healthy adults and in stroke patients. Hum Mov Sci 2003;22:221-36.

Sackley CM, Lincoln NB. Single blind randomized controlled trial of visual feedback after stroke: effects on stance symmetry and function. Disabil Rehabil 1997;19(12):536-46.

Dae-Jung Yang, Yo-Han Uhm. Effect of biofeedback postural control training on weight distribution rate and functional ability in stroke. Int J Contents 2013;9(4):1-3.

Leroux A, Pinet I, Nadeau S. Task-oriented intervention in chronic stroke: changes in clinical and laboratory measures of balance and mobility. Am J Phys Med Rehabil 2006;85(10):820-30.

Sze-Jia Hong. Reliability and validity of step test scores in subjects with chronic stroke. Arch Phys Med Rehabil 2012;93:1065-71.

Ji-Hye Jung, Si-Eun, Seung-Won Lee. Immediate effects of single leg stance exercise on dynamic balance, weight bearing and gait cycle in stroke patients. Phys Ther Rehabil Sci 2014;3(1):49-54.

Tae-Sung In, Yu-Ri Cha Jin-Hwa Jung, Kyoung-Sim Jung. Effects of visual feedback with a mirror on balance ability in patients with stroke. J Phys Ther Sci 2016;28(1):181–5.

Ramachandran VS, Rogers-Ramachandran D. Synaesthesia in phantom limbs induced with mirrors. Proc Biol Sci 1996;263:377– 86.

Van Peppen RPS. Effects of visual biofeedback therapy on postural control in bilateral standing after stroke: A systematic review. J Rehabil Med 2006;38:3-9.

Walker C, Brouwer BJ, Culham EG. Use of visual feedback in retraining balance following acute stroke. Phys Ther 2000;80(9):886-95.

Geiger RA. Balance and mobility following stroke: Effects of physical therapy interventions with and without biofeedback/force plate training. Phys Ther 2001;81(4):995-1005.