Abstract WP199: Enhancing Perception of Self-motion After Stroke Using Virtual Reality Affects Gait Adaptation in Those With High Levels of Gait Asymmetry

Abstract

Introduction: Perception of self-motion through virtual reality (VR) provides a unique avenue to mimic natural gait while walking in rehabilitation centers or clinics. This is important for enhancing gait rehabilitation in chronic stroke survivors. In this ongoing study, stroke survivors adapted to a split-belt paradigm and perception of self-motion was provided with a VR environment. Methods: Chronic stroke survivors (n=31; age=60.62±15.95years) were randomly put into a VR or a Non-VR group. The recruited subjects included a wide range in lower limb Fugl-Meyer scores (11-46) and baseline gait asymmetries. Participants walked at different belt speeds for each leg such that their baseline walking asymmetries were augmented. The VR stimuli consisted of walking in virtual corridor which provided the perception of self-motion that is natural during walking. Separate ANOVAs were done to demonstrate significant effects of adaptation conditions across the VR groups. Spatiotemporal measures (step length and step time asymmetries) as correlates of adaptation were compared with baseline asymmetries using Pearson correlation coefficients. Results: Spatial and temporal asymmetry measures showed strong adaptation effects on the split belt paradigm. These included step length asymmetry (p<0.001), limb excursion asymmetry (p<0.001), step time asymmetry (p<0.001), and stance time asymmetry (p<0.001). Significant relationships were demonstrated for step length asymmetry in the VR group (r=0.722, p<0.05) but not the Non-VR group (r=-0.457, p>0.116). A similar effect was also shown for step time asymmetry. Discussion: The results of our current study indicated a greater impact of VR in stroke survivors with high levels of spatial and/temporal gait asymmetries possibly due to VR allowing a better perception of the subject’s baseline gait asymmetries. A new AHA-funded project will investigate the impact of VR specifically on those with large baseline spatio-temporal gait asymmetries in addition to investigating how perceptions of visual and gait asymmetry affect such adaptations. Determination of these new relationships will improve our understanding towards gait rehabilitation after stroke to be better stratified and streamlined for greater benefit.