Background and purpose: Balance impairment is a major cause of falls in patients with hemiplegic stroke. The purpose of this study was to compare the effects of two balance training programs in these patients.

Materials and methods: A clinical trial with pretest–posttest design was conducted in 30 patients after a single hemisphere stroke that occurred at least 6 months before the study (2015). Patients were randomly assigned into either a control group or one of two balance rehabilitation groups. All groups received conventional physical therapy program. One group had a balance training program without visual cue while the other had balance training on unstable surface for 30 minutes 3 sessions per week. Patient performance was assessed before and one session after treatment using the time up and go (TUG) and four square steps (4SS) tests.

Results: All the patients had a significant clinical and functional improvement (P<0.05). No significant difference was found between the control group and the group who had balance training on unstable surface. But balance improved more in the group who received balance training without visual cue.

Conclusion: Balance training without visual input is more effective than balance training on unstable surface. To facilitate recovery of balance following stroke, rehabilitation programs that use visual deprivation to promote somatosensory and vestibular input are recommended.