Abstract

Rehabilitation interventions involving virtual reality (VR) technology have been developed for the promotion of functional independence post stroke. A scoping review was performed to examine the efficacy of VR-based interventions on balance and mobility disorders post stroke. Twenty-four articles in the English language examining VR game-based interventions and outcomes directed at balance and mobility disorders were included. Various VR systems (customized and commercially available) were used as rehabilitation tools. Outcome measures included laboratory and clinical measures of balance and gait. Outcome measures of dynamic balance showed significant improvements following VR-based interventions as compared to other interventions. Further, it was observed that VR-based intervention may have favorable effects in improving walking speed and the ability to deal with environmental challenges, which may also facilitate independent community ambulation. VR-based therapy thus has the potential to be a useful tool for balance and gait training for stroke rehabilitation. Utilization of motor learning principles related to task-related training may have been an important factor leading to positive results. Other principles such as repetition, feedback etc. were used in studies but were not explored explicitly and may need to be investigated to further improve the strength of results. Lastly, robust study designs with appropriate attention towards the intensity and dose-response aspects of VR training, clear study objectives and suitable outcomes would further aid in determining evidence-based efficacy for VR game-based interventions in the future.

Highlights

  • The length of in-hospital stay following an episode of stroke has consistently decreased [1,2,3], many individuals return home with residual deficits

  • Gait parameters at 2 week follow-up 4) 6MWT: No significant changes post-treatment observed in both groups

  • No difference between control and experimental groups were found post-training on any outcome. This scoping review was undertaken to appraise the impact of virtual reality (VR) intervention on balance and gait in people post-stroke

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Summary

Introduction

The length of in-hospital stay following an episode of stroke has consistently decreased [1,2,3], many individuals return home with residual deficits. Balance and gait deficits are commonly observed in this population, leading to reduced ambulatory activity [4], limitations in activities of daily living and community participation [5,6], physical inactivity and subsequent deterioration in quality of life [7,8]. VEs can be designed to resemble real-life scenarios including those encountered in the community [9,14]. VR affords therapists with the unique opportunity to expose and train patients in these scenarios in a riskfree, graded manner, while providing intensive training and multi-sensory feedback [15,16]

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