Comparison of multi-planar and sagittal-plane stepping machines for walking and balance restoration in chronic stroke: a randomized control trial (RCT)

Balance deficits are a common consequence of stroke, increasing the risk of falls. The Pinnacle Trainer (PT), which features a multi-planar exercise trajectory, has been shown to significantly activate hip abductors—key muscles for lateral stability. The elliptical trainer (ET), which simulates gait-like movement, is another commonly used rehabilitation tool. Both may offer viable options for gait training in individuals with chronic stroke. This study investigated the intervention effects of PT and ET on walking and balance abilities in individuals with chronic stroke. Thirty-six individuals with chronic stroke were randomly assigned to one of three groups: Pinnacle Trainer group (n = 12), ET group (n = 12), and control group (n = 12). Each group participated in an 8-week intervention program. The 6-minute walk test, 10-meter walk test, and the center of pressure (COP) displacements during obstacle crossing were measured as outcome measurements. The assessors (one therapist and one biomechanist) were blinded to the participants’ group assignments. All groups demonstrated significant improvements on the walking ability. Compared to the ET and control groups, the PT group showed significant improvements in mediolateral COP displacement, indicating enhanced balance and gait performance. These results support the integration of PT exercises into stroke rehabilitation programs targeting functional balance and mobility.