Comparison of robot-assisted gait training and visual feedback balance training on balance and gait outcomes in patients with stroke: a randomized controlled trial

Background Robot-assisted gait training and visual feedback balance training are technology-assisted approaches used to improve balance and mobility after stroke. Although both have demonstrated beneficial effects when incorporated into conventional rehabilitation, direct comparisons between these approaches under comparable treatment conditions remain limited.Objective This study aimed to compare the effects of RoboGait-based robot-assisted gait training and ProKin-252 visual feedback balance training on balance, mobility, gait, motor recovery, fear of falling, and functional independence after stroke.Methods This randomized, assessor-blinded, parallel-group trial included 50 participants with subacute or chronic stroke (mean age: 63.86 ± 9.06 years). Participants were allocated to RoboGait or ProKin-252 training. Both groups received conventional balance and gait rehabilitation for 40 min, 5 days/week for 4 weeks, with an additional 30-min technology-assisted intervention twice weekly. Outcomes were assessed at baseline and after 4 weeks. The Berg Balance Scale (BBS) was the primary outcome, analyzed using analysis of covariance adjusted for baseline BBS.Results Balance scores improved significantly in both groups (p < .001), with mean increases of 4.44 ± 1.71 points in the RoboGait group and 5.92 ± 1.91 points in the ProKin group. Adjusted post-treatment BBS favored ProKin, with a between-group difference of 1.43 points (95% CI, 0.37–2.49; p = .009). ProKin also produced greater improvements in fear of falling (p = .004) and forward–backward postural sway (p = .027). Functional mobility, gait speed, lower-extremity motor recovery, functional ambulation, and functional independence improved significantly in both groups without significant between-group differences.Conclusion Both groups demonstrated improvements in balance and functional outcomes. ProKin produced a statistically greater improvement in BBS and additional advantages in fear of falling and forward–backward postural sway; however, the adjusted BBS difference was modest, with no significant between-group differences in gait or broader functional outcomes.