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Abstract.[Purpose] The aim of this study was to examine the effects of horseback riding simulator exercise on postural balance of chronic stroke patients.[Subjects] A total of 67 stroke patients were assigned either to a horseback riding simulator exercise group (HEG, n=34) or a mat exercise group (MEG, n=33).[Methods] The subjects exercised three times per week for 8 weeks. Static balance ability was determined by eyes open balance (EOB) and eyes closed balance (ECB), which was measured using a Kinesthetic Ability Trainer Balance system. Dynamic balance was evaluated using the Berg balance scale (BBS).[Results] EOB and ECB significantly decreased and BBS had significantly increased after the intervention in the HEG and the MEG, and ECB decreased and BBS increased significantly more in the HEG than in the MEG.[Conclusion] Horseback riding simulator exercise is more effective than mat exercise for improving the ECB and BBS of stroke patients.