Chronic stroke often results in balance and gait impairments, significantly impacting patients’ quality of life. The purpose of this study was to investigate whether the combined effect of unstable surface balance training and visual feedback, based on proprioceptive neuromuscular stimulation in patients with chronic stroke, is effective in restoring balance and gait ability. A total of 39 chronic stroke patients were randomly assigned to a visual feedback combined with unstable surface balance training group (VUSBG), an unstable surface balance training group (USBG), or a conventional physical therapy group (CG). This study was conducted with the Trunk Impairment Scale, the Bug Balance Scale, the Timed Get Up and Go Test, and Gait Analysis. VUSBG and USBG improved function and gait (stride length and hip/knee flexion angle), but there was no significant difference in the CG group. Specific results showed that the stride length in the VUSBG improved by 25% (p < 0.05), and the hip/knee flexion angle improved by 18% (p < 0.05). The post-hoc analysis revealed that VUSBG had a greater impact on the hip/knee flexion angle relative to the other two groups, as well as gait velocity and stride length relative to CG. Visual feedback complex exercise based on the principle of proprioceptive neuromuscular facilitation could be an intervention strategy to improve gait speed, trunk stability, and mobility in chronic stroke patients.

Background: Prolonged tablet use for digital handwriting is increasingly common in educational settings, yet optimal ergonomic positioning remains unclear. This exploratory, cross-sectional study examined how tablet tilt angle affects hand and wrist muscle activation patterns during digital handwriting. Methods: This cross-sectional study recruited fifteen healthy university students (age 22.3 ± 2.2 years) who completed standardized writing tasks at three tablet tilt angles (0°, 20°, 60°). Surface electromyography recorded activation from four muscles responsible for the dynamic tripod grip: abductor pollicis brevis (APB), flexor pollicis longus (FPL), flexor digitorum superficialis (FDS), and extensor carpi ulnaris (ECU). Results: Significant differences in muscle activation were observed across angles (p < 0.05) for three muscles. APB activation was higher at 0° (18.68 ± 11.88% MVIC) and 20° (18.72 ± 12.13% MVIC) than at 60° (14.67 ± 10.38% MVIC), while FDS use decreased from 0° (10.98 ± 4.80% MVIC) to 60° (6.43 ± 3.14% MVIC). Conversely, ECU use increased from 0° (11.76 ± 6.96% MVIC) to 60° (16.15 ± 8.02% MVIC). FPL showed no significant differences. Conclusions: Tablet tilt angle substantially affects neuromuscular activation patterns during digital handwriting. In healthy young adults, these findings may help inform preventive ergonomic strategies for prolonged tablet handwriting; however, direct clinical extrapolation requires validation in clinical and more diverse populations.