Effect of Incorporating Perceptual Learning Into Plantar Hardness Discrimination on the Risk of Falling and Muscle Torque in Patients With Hemiplegia: A Randomized Controlled Trial
In brief
Plantar hardness training lowered fall-risk scores in 34 stroke patients
In this small randomized trial, adding training to distinguish plantar hardness to physical rehabilitation led to lower fall-risk scores, stronger knee extensor torque and better functional independence than rehabilitation alone. The study measured a balance-system score, not actual falls, and does not establish whether benefits last or translate into fewer falls in daily life.
- Journal
- American journal of physical medicine & rehabilitation (Q1)
- Published
- 29 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Lama Saad El-Din Mahmoud, Hanaa S Mohamed, Marian M Shafeek, Mohammed Saad El-Din Mahmud, Hanan Hosny M Battesha
- PMID
- 42952006
- DOI
- 10.1097/PHM.0000000000003194
Why clinicians should know about it
- Picked for Rehabilitation (paper of the day, 30 October 2026): RCT shows perceptual learning reduces falls, improves torque, FIM
Abstract
OBJECTIVES: This study aims to evaluate the impact of perceptual training involving plantar hardness discrimination on fall risk and muscle torque in individuals with hemiplegia. DESIGN: A randomized controlled trial was conducted in thirty-four stroke patients were randomly assigned to the study and control groups in equal numbers and assessed both before and after treatment. The outcome evaluations comprised fall risk assessment by the Biodex Balance System (BBS), the Isokinetic assessment of lower-limb muscle torque, and the Functional Independent Measures Scale (FIM). Each group was given a selected physical treatment program, while the study group also received perceptual learning with plantar hardness discrimination. RESULTS: Post-treatment comparison revealed that the study group exhibited a significantly lower risk of falling than the control group (P <0.001, effect size [ES]=1.48). Similarly, knee extensors torque increased significantly in the study group relative to the control group (P <0.001, ES=1.19). Additionally, the study group showed a significant rise in FIM scores compared with the control group (P <0.001, ES=1.56). CONCLUSIONS: For stroke patients, incorporating perceptual learning into plantar hardness discrimination in the rehabilitation program is regarded as beneficial physical therapy neurorehabilitation for enhancing risk of falling, lower limb muscle torque and function.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.