Improvement in balance using a virtual reality-based stepping exercise: a randomized controlled trial involving individuals with chronic stroke

Abstract

Objective:

To study the clinical effectiveness and the usability of a virtual reality-based intervention compared with conventional physical therapy in the balance recovery of individuals with chronic stroke.

Design:

Randomized controlled trial.

Setting:

Outpatient neurorehabilitation unit.

Participants:

A total of 20 individuals with chronic stroke.

Interventions:

The intervention consisted of 20 one-hour sessions, five sessions per week. The experimental group combined 30 minutes with the virtual reality-based intervention with 30 minutes of conventional training. The control group underwent one hour conventional therapy.

Main measures:

Balance performance was assessed at the beginning and at the end of the trial using the Berg Balance Scale, the balance and gait subscales of the Tinetti Performance-Oriented Mobility Assessment, the Brunel Balance Assessment, and the 10-m Walking Test. Subjective data of the virtual reality-based intervention were collected from the experimental group, with a feedback questionnaire at the end of the trial.

Results:

The results revealed a significant group-by-time interaction in the scores of the Berg Balance Scale (p < 0.05) and in the 10-m Walking Test (p < 0.05). Post-hoc analyses showed greater improvement in the experimental group: 3.8 ±2.6 vs. 1.8 ±1.4 in the Berg Balance Scale, –1.9 ±1.6 seconds vs. 0.0 ±2.3 seconds in the 10-m Walking Test, and also in the number of participants who increased level in the Brunel Balance Assessment (χ² = 2.5, p < 0.01).

Conclusions:

Virtual reality interventions can be an effective resource to enhance the improvement of balance in individuals with chronic stroke.