Abstract
BackgroundA stroke often results in gait impairments, activity limitations and restricted participation in daily life. Virtual reality (VR) has shown to be beneficial for improving gait ability after stroke. Previous studies regarding VR focused mainly on improvements in functional outcomes. As participation in daily life is an important goal for rehabilitation after stroke, it is of importance to investigate if VR gait training improves participation. The primary aim of this study is to examine the effect of VR gait training on participation in community-living people after stroke.Methods/designThe ViRTAS study comprises a single-blinded, randomized controlled trial with two parallel groups. Fifty people between 2 weeks and 6 months after stroke, who experience constraints with walking in daily life, are randomly assigned to the virtual reality gait training (VRT) group or the non-virtual reality gait training (non-VRT) group. Both training interventions consist of 12 30-min sessions in an outpatient rehabilitation clinic during 6 weeks. Assessments are performed at baseline, post intervention and 3 months post intervention. The primary outcome is participation measured with the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P). Secondary outcomes are subjective physical functioning, functional mobility, walking ability, walking activity, fatigue, anxiety and depression, falls efficacy and quality of life.DiscussionThe results of the study provide insight into the effect of VR gait training on participation after stroke.Trial registrationNetherlands National Trial Register, Identifier NTR6215. Registered on 3 February 2017.
Highlights
A stroke often results in gait impairments, activity limitations and restricted participation in daily life
The Virtual Reality Training After Stroke (ViRTAS) study examines the effect of Virtual reality (VR) gait training on participation in community-living people between 2 weeks and 6 months after stroke
VR can be defined as a computer-based technology that simulates a real environment and provides the user with opportunities to interact with objects and events [20, 58]
Summary
A stroke often results in gait impairments, activity limitations and restricted participation in daily life. Virtual reality (VR) has shown to be beneficial for improving gait ability after stroke. As participation in daily life is an important goal for rehabilitation after stroke, it is of importance to investigate if VR gait training improves participation. A stroke may lead to a wide range of impairments affecting sensory, motor, cognitive and visual function. Impairment in motor function of the legs, leads to commonly seen gait deficits following stroke [3, 4]. Rehabilitation interventions in virtual environments can manipulate practice conditions to engage motivation, motor control, cognitive processes and sensory feedback-based learning mechanisms [17]. Principles of motor learning can be well applied in VR training by providing goal-oriented, repetitive and varied practice that is adjusted to the abilities of the patient [18]. VR interventions to train gait frequently comprise treadmill training systems in combination with a screen or a head-mounted device to create an immersive environment [16]
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