Feasibility and Effectiveness of Virtual Reality Training on Balance and Gait Recovery Early after Stroke: A Pilot Study

Abstract

Objective: To investigate the feasibility and effectiveness of virtual reality training for improving balance and/or gait during inpatient rehabilitation of patients within 12 weeks after stroke. Methods:Sixteen patients within 12 weeks after stroke and dependent gait as categorised with a Functional Ambulation Category score of 2 or 3 were included in this longitudinal pilot study. Participants received eight 30-min sessions of virtual reality training during four weeks as part of the regular inpatient rehabilitation program. Feasibility was assessed using compliance with the training, adverse events, experiences of the participants and the physiotherapists; and effectiveness with the Berg Balance Scale, centre of pressure velocity, Functional Ambulation Category and 10-meter walking test.Results: Participants positively evaluated the intervention and enjoyed the training sessions. Also, physiotherapists observed the training as feasible and beneficial for improving balance or gait. Compliance with the training was 88% and no serious adverse events occurred. The Berg Balance Scale, anterior-posterior centre of pressure velocity, Functional Ambulation Category and 10-meter walking test showed significant improvement after four weeks of training (p<0.05). Conclusion:This study demonstrates that virtual reality training in patients early after stroke is feasible and may be effective in improving balance and/or gait ability.

Feasibility of ActivABLES to promote home-based exercise and physical activity of community-dwelling stroke survivors with support from caregivers: A mixed methods study

“…On the other hand, informal caregivers often lack knowledge and support and they need more education on how they can provide support with exercise and physical activity [22,23]. Many studies have revealed a need for practical support for stroke survivors and their informal caregivers to help them engage in home-based exercise [10], and recent studies have suggested support could be provided by technical applications [24][25][26][27].…”

Virtual reality training enhances gait poststroke: a systematic review and meta‐analysis

“…107,109 Likewise, though not evaluated in our review, VR training was also beneficial for balance-related outcomes in stroke survivors. Many of the included studies in our review reported an enhancement in static and dynamic balance with VR as demonstrated by an increased Berg balance score, 64,83,88 timed up and go test, 70,84 and functional reach test. 64,67 Here, the literature suggests that the rehabilitation by VR was superior compared with conventional therapy because of its ability to allow a multisensory learning environment and its ability to motivate and simulate new motor and sensory abilities responsible for maintaining balance.…”

“…Of the 32 included studies, 20 were RCTs 58-77 and 12 were CCTs. [78][79][80][81][82][83][84][85][86][87][88][89] Interventions Of all the included studies, 18 analyzed the influence of VR training on gait parameters, 39,60,[63][64][65][66]69,[71][72][73]75,77,78,[81][82][83][84][85]87 eight used VR in adjunct with treadmill, 61,62,64,67,68,70,77,89 and six used VR with robot-assisted training. 58,59,74,79,80,86 In terms of control interventions for 20 RCTs, the influence of VR training was compared in nine studies with conventional rehabilitation, 60,63,65,67,…”

“…VR. The subgroup analysis of studies only using VR (seven studies 59,63,[71][72][73]76,83 ; N = 80) as an intervention revealed a medium significant effect size for cadence (Fig. S23, online only) in the positive domain (Hedge's g = 0.68, 95% CI: 0.37-0.99) with no heterogeneity (I 2 = 0%, P < 0.01).…”

Virtual reality gait training versus non-virtual reality gait training for improving participation in subacute stroke survivors: study protocol of the ViRTAS randomized controlled trial

“…The GRAIL consists of a dual-belt treadmill with force platform, a motion-capture system (Vicon Motion Systems, Oxford, UK) and a 180° semi-cylindrical screen for the projection of environments with optic flow (Fig. 3) [28]. During the training sessions participants wear a safety harness that is attached to an overhead suspension system.…”