Effect of the multimodal vestibular training on balance and quality of life in stroke survivors: a randomized controlled trial

Post-stroke balance impairment is multifactorial, and limited evidence is available on whether Multimodal Vestibular Training (MVT) provides additional benefits when added to conventional balance training. This study investigated the effect of a four-week MVT program on balance, functional mobility, and quality of life in chronic stroke survivors. After screening 25 stroke patients, 21 eligible chronic stroke survivors were enrolled.

Participants were aged 30–75 years, had stroke duration of at least six months, could walk at least 10 m safely under supervision, had MMSE scores ≥ 24, and had Berg Balance Scale scores > 21. Participants were randomly assigned to the experimental group (n = 11), which received MVT with conventional balance training, or the control group (n = 10), which received conventional balance training only. Both groups received three supervised 45-minute sessions per week for four weeks.

Outcomes were assessed at baseline and post-intervention using the Timed Up and Go (TUG) test, Berg Balance Score (BBS), and Stroke-Specific Quality of Life questionnaire (SS-QoL). Eighteen participants completed the post-intervention assessment and were included in the final analysis, with nine participants in each group. No significant baseline differences were observed between groups.

Post-intervention analysis showed significantly better TUG scores in the experimental group than the control group, (p = 0.002), and significantly better SS-QoL scores (p = 0.006). Post-intervention BBS scores did not differ significantly between groups (p = 0.924). Change-score analysis showed significantly greater improvement in the experimental group for TUG (p = 0.042), BBS (p = 0.013), and SS-QoL (p = 0.023).

The findings suggest that MVT, when added to conventional rehabilitation, may be associated with improvements in functional mobility and selected quality-of-life outcomes in chronic stroke survivors. BBS scores improved over time, although the post-intervention between-group difference was not significant. Given the limited sample size and short intervention duration, these findings should be interpreted as preliminary and confirmed in larger adequately powered randomized controlled trials.

Trial registration: The study protocol was prospectively registered online in the Clinical Trial Registry India (CTRI) at https//www.ctri.nic.in/ with the identifier CTRI/2023/12/060822 dated 18/12/2023. The authors extend their appreciation to the Ongoing Research Funding program, Research Chairs (ORF-RC-2026-10-07), King Saud University, Riyadh, Saudi Arabia for funding this study. This study was funded by the Ongoing Research Funding program, Research Chairs (ORF-RC-2026-10-07), King Saud University, Riyadh, Saudi Arabia.