Daniel McEwen1, Anne Taillon-Hobson1, Martin Bilodeau1, Heidi Sveistrup1, Hillel Finestone2. 1. From the Bruyère Research Institute, Ottawa, Ontario, Canada (D.M., A.T.-H., M.B., H.F.); School of Rehabilitation Sciences (D.M., M.B., H.S.), School of Human Kinetics (M.B., H.S., H.F.), and Faculty of Medicine (H.F.), University of Ottawa, Ottawa, Ontario, Canada; and Department of Physical Medicine and Rehabilitation, Elisabeth Bruyère Hospital, Ottawa, Ontario, Canada (H.F.). 2. From the Bruyère Research Institute, Ottawa, Ontario, Canada (D.M., A.T.-H., M.B., H.F.); School of Rehabilitation Sciences (D.M., M.B., H.S.), School of Human Kinetics (M.B., H.S., H.F.), and Faculty of Medicine (H.F.), University of Ottawa, Ottawa, Ontario, Canada; and Department of Physical Medicine and Rehabilitation, Elisabeth Bruyère Hospital, Ottawa, Ontario, Canada (H.F.). hfinestone@bruyere.org.
Abstract
BACKGROUND AND PURPOSE:Exercise using virtual reality (VR) has improved balance in adults with traumatic brain injury and community-dwelling older adults. Rigorous randomized studies regarding its efficacy, safety, and applicability with individuals after stroke are lacking. The purpose of this study was to determine whether an adjunct VR therapy improves balance, mobility, and gait in stroke rehabilitation inpatients. METHODS: A blinded randomized controlled trial studying 59 stroke survivors on an inpatient stroke rehabilitation unit was performed. The treatment group (n=30) received standard stroke rehabilitation therapy plus a program of VR exercises that challenged balance (eg, soccer goaltending, snowboarding) performed while standing. The control group (n=29) received standard stroke rehabilitation therapy plus exposure to identical VR environments but whose games did not challenge balance (performed in sitting). VR training consisted of 10 to 12 thirty-minute daily sessions for a 3-week period. Objective outcome measures of balance and mobility were assessed before, immediately after, and 1 month after training. RESULTS: Confidence intervals and effect sizes favored the treatment group on the Timed Up and Go and the Two-Minute Walk Test, with both groups meeting minimal clinical important differences after training. More individuals in the treatment group than in the control group showed reduced impairment in the lower extremity as measured by the Chedoke McMaster Leg domain (P=0.04) immediately after training. CONCLUSIONS: This VR exercise intervention for inpatient stroke rehabilitation improved mobility-related outcomes. Future studies could include nonambulatory participants as well as the implementation strategies for the clinical use of VR. CLINICAL TRIAL REGISTRATION URL: http://www.ANZCTR.org.au/. Unique identifier: ACTRN12613000710729.
RCT Entities:
BACKGROUND AND PURPOSE: Exercise using virtual reality (VR) has improved balance in adults with traumatic brain injury and community-dwelling older adults. Rigorous randomized studies regarding its efficacy, safety, and applicability with individuals after stroke are lacking. The purpose of this study was to determine whether an adjunct VR therapy improves balance, mobility, and gait in stroke rehabilitation inpatients. METHODS: A blinded randomized controlled trial studying 59 stroke survivors on an inpatient stroke rehabilitation unit was performed. The treatment group (n=30) received standard stroke rehabilitation therapy plus a program of VR exercises that challenged balance (eg, soccer goaltending, snowboarding) performed while standing. The control group (n=29) received standard stroke rehabilitation therapy plus exposure to identical VR environments but whose games did not challenge balance (performed in sitting). VR training consisted of 10 to 12 thirty-minute daily sessions for a 3-week period. Objective outcome measures of balance and mobility were assessed before, immediately after, and 1 month after training. RESULTS: Confidence intervals and effect sizes favored the treatment group on the Timed Up and Go and the Two-Minute Walk Test, with both groups meeting minimal clinical important differences after training. More individuals in the treatment group than in the control group showed reduced impairment in the lower extremity as measured by the Chedoke McMaster Leg domain (P=0.04) immediately after training. CONCLUSIONS: This VR exercise intervention for inpatient stroke rehabilitation improved mobility-related outcomes. Future studies could include nonambulatory participants as well as the implementation strategies for the clinical use of VR. CLINICAL TRIAL REGISTRATION URL: http://www.ANZCTR.org.au/. Unique identifier: ACTRN12613000710729.
Authors: S Bonavita; L Lavorgna; G Abbadessa; F Brigo; M Clerico; S De Mercanti; F Trojsi; G Tedeschi Journal: J Neurol Date: 2021-05-20 Impact factor: 4.849
Authors: L Sheehy; A Taillon-Hobson; H Sveistrup; M Bilodeau; D Fergusson; D Levac; H Finestone Journal: BMC Neurol Date: 2016-03-31 Impact factor: 2.474