Abstract
BackgroundMultisensory interactive training has an increasingly prominent role in stroke rehabilitation. Currently, there is insufficient evidence to demonstrate its efficacy on gait improvement, upper limb and lower limb functional improvement, global motor function and cognitive improvement. A recent Cochrane review confirmed that published studies on virtual reality (VR) training have the limitations of lack of powered sample size, did not evaluate the benefits over a long-term period and lacked trial quality on cognitive function. Another systematic review also concluded that the evidence for the use of VR in gait and balance improvement is limited. This study investigates the effects of multisensory training on gait pattern, upper and lower limb biomechanics, upper limb gross and fine motor functions, and lower limb functional recovery over a medium- to long-term period.MethodsTwo hundred and twenty-four acute stroke patients will be recruited from a single centre over a period of 6 years. Participants will be randomly assigned to either conventional therapy or conventional therapy with VR training. Outcomes will be recorded at baseline, post intervention and at 3, 6 and 12 months post intervention. Primary outcome measure is gait speed. Secondary outcome measures include kinematic data of upper and lower limb motion, muscle tone, Action Research Arm Test and Short Orientation Memory Concentration Test.DiscussionThe results of this trial will provide in-depth understanding of the effect of early VR interventions on gait, upper and lower limb biomechanics and how it may relate to changes in functional outcomes and muscle tone.Trial registrationChinese Clinical Trial Registry (Registration No.: ChiCTR-IOC-15006064). Registered on 11 May 2015.
Highlights
Multisensory interactive training has an increasingly prominent role in stroke rehabilitation
The concept of using commercial gaming (CG) systems to deliver virtual reality (VR) interventions at home as part of the rehabilitation programme was well received among stroke survivors as they believed it to be beneficial for functional recovery [8]
Previous studies on VR interventions indicated that they may be more effective in improving gait, lower limb functions [9, 10] and upper limb functions [11] when compared to conventional therapy
Summary
Multisensory interactive training has an increasingly prominent role in stroke rehabilitation. There is insufficient evidence to demonstrate its efficacy on gait improvement, upper limb and lower limb functional improvement, global motor function and cognitive improvement. A recent Cochrane review confirmed that published studies on virtual reality (VR) training have the limitations of lack of powered sample size, did not evaluate the benefits over a long-term period and lacked trial quality on cognitive function. This study investigates the effects of multisensory training on gait pattern, upper and lower limb biomechanics, upper limb gross and fine motor functions, and lower limb functional recovery over a medium- to long-term period. Previous studies on VR interventions indicated that they may be more effective in improving gait, lower limb functions [9, 10] and upper limb functions [11] when compared to conventional therapy. The latest published meta-analysis [7] suggested that VR interventions are at least as effective as conventional physiotherapy in improving lower limb outcomes within the stroke population
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