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Effects of a Cognitive Behavioral Therapy Program Combined with an Exercise Therapy Program on Balance, Gait, EEG, and Quality of Life in Patients with Chronic Stroke

  • Journal of the Korean Society of Physical Medicine
  • Abbr : J Korean Soc Phys Med
  • 2026, 21(3), pp.1~11
  • Publisher : The Korean Society of Physical Medicine
  • Research Area : Medicine and Pharmacy > Physical Therapy > Other physical therapy
  • Received : September 30, 2025
  • Accepted : December 17, 2025
  • Published : August 31, 2026

장유경 1

1호남대학교

Accredited

ABSTRACT

PURPOSE: This study investigated the effects of exercise therapy combined with cognitive behavioral therapy (CBT) on balance, gait endurance, electroencephalography (EEG), heart rate variability (HRV), and quality of life in patients with chronic stroke. METHODS: Fifteen patients with chronic stroke participated in a four-week intervention program conducted three times per week. Each session consisted of 10 minutes of CBT followed by exercise therapy. Balance was assessed using the BioRescue system by measuring the center of pressure sway area and path length. Gait endurance was evaluated using the 6-Minute Walk Test (6MWT), and quality of life was assessed using the Korean version of the Stroke-Specific Quality of Life Scale (SSQOL-K). Neurophysiological and autonomic nervous system responses were evaluated using the EEG alpha peak and the HRV low-frequency/high-frequency ratio, respectively. Pre- and post-intervention outcomes were compared using paired t-tests or Wilcoxon signed-rank tests, with the significance level set at α = .05. RESULTS: Following the intervention, balance improved significantly, as demonstrated by reductions in the sway area and path length (p < .05). The 6MWT distance increased significantly from 479.21 ± 294.46 m to 596.21 ± 276.60 m (p < .05). The SSQOL-K score also increased significantly from 171.27 ± 13.41 to 178.07 ± 14.20 (p < .001). However, no significant changes were observed in the EEG alpha peak or HRV low-frequency/high-frequency ratio. CONCLUSION: Exercise therapy combined with CBT effectively improved balance, gait endurance, and quality of life in patients with chronic stroke. Integrating psychological interventions into physical rehabilitation may facilitate more comprehensive recovery. Further controlled studies with larger samples are required to determine its neurophysiological and autonomic effects.

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