Clinical usefulness of the virtual reality-based postural control training on the gait ability in patients with stroke

Abstract

This study is a single blind randomized controlled trial to determine the effect of virtual reality-based postural control training on the gait ability in patients with chronic stroke. Sixteen subjects were randomly assigned to either experimental group (VR, n= 8) or control group (CPT, n= 8). Subjects in both groups received conventional physical therapy for 60 min per day, five days per week during a period of four weeks. Subjects in the VR group received additional augmented reality-based training for 30 min per day, three days per week during a period of four weeks. The subjects were evaluated one week before and after participating in a four week training and follow-up at one month post-training. Data derived from the gait analyses included spatiotemporal gait parameters, 10 meters walking test (10 mWT). In the gait parameters, subjects in the VR group showed significant improvement, except for cadence at post-training and follow-up within the experimental group. However, no obvious significant improvement was observed within the control group. In between group comparisons, the experimental group (VR group) showed significantly greater improvement only in stride length compared with the control group (P< 0.05), however, no significant difference was observed in other gait parameters. In conclusion, we demonstrate significant improvement in gait ability in chronic stroke patients who received virtual reality based postural control training. These findings suggest that virtual reality (VR) postural control training using real-time information may be a useful approach for enhancement of gait ability in patients with chronic stroke.

Rehabilitation that incorporates virtual reality is more effective than standard rehabilitation for improving walking speed, balance and mobility after stroke: a systematic review

“…All trials were analysed on a per protocol basis. There were no marked differences in quality between the studies that had the same duration of treatment in both the experimental and control groups 41,[43][44][45]47,[49][50][51][52]54,56 and the studies that added VRBR to standard rehabilitation in order to produce a greater amount of treatment in the experimental group. 42,48,53,55 Participants…”

“…[41][42][43][44][45][47][48][49][50][51][52][53][54][55][56] Hand searching did not identify any additional papers. The flow of studies through the review is shown in Figure 1.…”

“…The included studies took place in seven countries: eight trials took place in Korea, [47][48][49][52][53][54][55][56] two in the USA, 41,44 one in Taiwan, 51 one in Singapore, 43 one in Brazil, 42 one in Spain 50 and one in Italy. 45 …”

“…The majority of the studies enrolled subjects who had had an episode of ischaemic stroke more than 6 months before enrolment into the study. Where reported, they had preserved ability to walk with or without an assistive device 44,45,[47][48][49][52][53][54] or the ability to maintain an upright posture. 42,50 Intervention…”

“…41,52,56 One study used the head-mounted device without a treadmill. 54 For balance training, one study 43 used Microsoft Xbox 360 Kinect a , one study 45 used Nintendo Wii Fit b and one study 50 used an audio-visual system combined with a motion-tracking system in order to immerse participants in a 3D virtual environment. In the study of Mirelman and colleagues, 44 a robotic virtual reality device was used for training movement of the lower extremity.…”