###### Abstract  
This study investigated the effects of virtual reality (VR)-based training combined with preliminary trunk stabilization education on postural control and balance in stroke patients. A single-blind randomized controlled trial enrolled 30 participants, randomly divided into a trunk stabilization group (\(n=15\)) and a control group (\(n=15\)). The trunk stabilization group engaged in 10 min of trunk stabilization education followed by 20 min of VR-based training, three times weekly for three weeks. The control group participated only in VR-based training. Outcomes were assessed using the Korean Trunk Impairment Scale (K-ITS), Postural Assessment Scale for Stroke (PASS), Berg Balance Scale (BBS), limit of stability (LOS), and center of pressure (COP) measurements. Both groups significantly improved in all measured outcomes post-intervention (\(p<0.05\)). Notably, the trunk stabilization group exhibited significantly superior improvements in the K-ITS, PASS, BBS, LOS, and COP path length compared to the control group (\(p<0.05\)). These results highlight the enhanced effectiveness of integrating trunk stabilization education with VR-based training, suggesting that it not only yields statistically significant improvements but also provides clinically meaningful benefits for functional postural control and balance recovery in stroke rehabilitation. trunk stabilization; virtual reality rehabilitation; stroke; posture control; balance 2025 15, 7620 15  
and standing balance, walking ability, and daily functioning in patients with stroke [7]. Additionally, it contributes to improved weight-bearing, muscle strength, and postural control, facilitating better dynamic balance and mobility during stroke recovery [8]. Virtual reality (VR)-based training is a therapeutic intervention that can enhance balance following stroke. This method offers a realistic and immersive environment by integrating multisensory stimuli (visual, auditory, tactile, and somatosensory inputs) and promotes functional recovery through goal-directed motivational tasks [9]. According to [PERSON] and [PERSON] [10], VR creates a rich environment for acquiring new skills and can help resolve functional issues in patients with stroke while increasing engagement and enjoyment. The motivational aspect of VR training makes it more appealing and engaging than traditional therapeutic exercises and leads to increased concentration and adherence [11; 12; 13]. [PERSON] and [PERSON] [14] demonstrated that VR-based video games offering visual and auditory feedback effectively improve postural control and gait ability in patients with chronic stroke. Similarly, [PERSON] et al. [15] reported improved trunk control and balance with VR-based video game interventions. However, goal-oriented tasks, such as those in VR training, may lead patients to focus more on task completion than on movement quality, potentially reinforcing abnormal compensatory patterns and resulting in inefficient motor recovery [16]. Although functional recovery is the primary goal of post-stroke rehabilitation, compensatory strategies are often used instead of normal motor function. The repeated use of such compensation may result in chronic joint pain and dysfunctional movement patterns [16]. Patients with stroke often exhibit altered muscle recruitment sequences due to impaired selective motor control, making them susceptible to abnormal compensation during VR training [17]. This compensation may worsen trunk dysfunction and postural asymmetry, compromising balance responses and control mechanisms [4]. To address these limitations, [PERSON] [18] emphasized the importance of trunk stabilization in their systematic review. Maintaining a neutral spine and co-contraction of the trunk muscles are critical for postural control in patients with stroke.