Effectiveness of immersive virtual reality training to improve sitting balance control among individuals with acute and sub-acute paraplegia: A randomized clinical trial

Abstract

Objectives: Spinal cord injury (SCI) is a disabling condition with physical, psychological, and financial consequences. The study’s goal is to compare the effectiveness of immersive virtual reality (VR) training in balance among individuals with incomplete paraplegia to that of functional electrical stimulation (FES). Design: Two groups, randomized clinical trial. Setting: Neurological Physiotherapy Out Patient Department, Tertiary Care Hospital. Participants: Eighteen people aged 18–60 years with incomplete SCI. Interventions: VR training along with conventional physical therapy (CPT) and FES for Rectus Abdominis and Erector Spinae with CPT five times a week for 4 weeks. Outcome Measures: The outcome measures were Modified Functional Reach Test (mFRT) and Function in Sitting Test (FIST) to assess sitting balance and Spinal Cord Independence Measure III (SCIM III) for the level of independence. Assessments were taken before initiating treatment and at the end of the 2 and 4 weeks after treatment. Within-group analyses for the mFRT values were performed using Repeated Measures ANOVA test, and between-group analyses were performed using the independent t-test test. Friedman and Mann–Whitney U-tests were used for analyzing FIST and SCIM III. Results: All variables (mFRT and FIST) improved significantly in both groups (P < 0.05), with the VR + CPT group showing a more significant result than the FES + CPT group (P value < 0.05), except for SCIM III. Conclusion: VR as an adjunct to CPT demonstrated proved to be an effective treatment to improve balance among individuals with incomplete paraplegia. Trial registration: Clinical Trials Registry India identifier: CTRI/2020/03/024080.