Combination Of Virtual Reality Research Articles

Virtual reality and neurofeedback as a supportive approach to managing cancer symptoms for patients receiving treatment: A brief report of a feasibility trial.

Managing cancer symptoms while patients receive systemic treatment remains a challenge in oncology. The use of complementary and alternative medicine (CAM) approaches like virtual reality (VR) and neurofeedback (NF) in tandem with systemic treatment might reduce symptom burden for patients. The combination of VR + NF as a CAM intervention approach is novel and understudied, particularly as it relates to supportive cancer care. The purpose of this study is to summarize our VR + NF study protocol and share preliminary results regarding study retention (across 2 treatment sessions) and preliminary impact of VR or VR + NF on patient-reported outcomes such as anxiety and pain. We utilized a parallel arm trial design to compare preliminary impact of VR only and VR + NF on cancer symptoms among patients who are actively receiving cancer treatment. Sixty-seven percent (n = 20) of participants returned to participate in a second VR session, and the rates of return were the same between the VR groups. Patients in the VR + NF group showed improvements in anxiety after both sessions, while patients in the VR only group showed significant improvements in pain and depression after both sessions. Patients in the VR + NF group showed improved pain after session 1. This study demonstrates that patients can be retained over multiple treatment sessions and that VR and NF remain promising treatment approaches with regard to impact on patient-reported outcomes like anxiety and pain.

Effects of virtual reality versus motor imagery versus routine physical therapy in patients with parkinson’s disease: a randomized controlled trial

BackgroundParkinson’s Disease (PD) is the second most common progressive neurodegenerative disorder, mostly affecting balance and motor function caused mainly by a lack of dopamine in the brain. The use of virtual reality (VR) and motor imagery (MI) is emerging as an effective method of rehabilitation for people with Parkinson’s disease. Motor imagery and virtual reality have not been compared in patients with Parkinson’s disease. This randomized clinical trial is unique to compare the effects of virtual reality with routine physical therapy, motor imagery with routine physical therapy, and routine physical therapy alone on balance, motor function, and activities of daily living in patients with Parkinson’s disease.MethodsA total of sixty patients with Parkinson’s disease were randomized into three groups using lottery method; twenty with virtual reality therapy in addition to physical therapy (group A = VR + RPT), twenty with imagery therapy in addition to physical therapy (group B = MI + RPT), and twenty were treated with only routine physical therapy (group C = RPT). All patients were evaluated using the Unified Parkinson’s Disease Rating Scale (UPDRS) for motor function and activities of daily living, the Berg balance scale (BBS) for balance, and the Activities-specific Balance Confidence Scale (ABCs) for balance confidence at baseline, six and twelve weeks, and one month after treatment discontinuation. The one-way ANOVA was used to compare the outcomes between three groups, and the repeated measures ANOVA was used to compare the outcomes within each of the three groups at a significance level of p-value = 0.05.ResultsAccording to UPDRS III, the VR + RPT group showed significant improvement in motor function, compared to the MI + RPT and RPT groups, as the Mean ± SD at baseline was 33.95 ± 3.501 and at the 12-week assessment was 17.20 ± 9.451 with a p-value = 0.001. In the VR + RPT group, the BBS score at baseline was 37.15 ± 3.437 and at 12th week was 50.10 ± 4.897 with a p-value = 0.019. Among the VR + RPT group, the ABCS score showed significant improvement as the M ± SD at baseline was 57.95 ± 4.629, and at the 12th week was 78.59 ± 6.386 with a p-value = 0.010. At baseline, the UPDRS II for activities of daily living in the VR + RPT group was 25.20 ± 3.036 and at 12th week it was 15.30 ± 2.364 with p-value of 0.000.ConclusionThe current study found that the combination of VR and RPT proved to be the most effective treatment method for improving balance, motor function, and activities of daily living in patients with Parkinson’s disease when compared to MI + RPT or RPT alone.

A low-cost, wireless, 4-channel EEG measurement system used in virtual reality environments

The combination of Virtual Reality (VR) technology and Electroencephalography (EEG) measurements has shown tremendous potential in the fields of psychology and neuroscience research. However, the majority of EEG measurement devices currently available are expensive, bulky, uncomfortable to wear, and difficult to integrate with VR headsets. These limitations have hindered the development of related research fields. This study describes a low-cost (60.07 USD), small-sized, wireless, high-precision, low-power consumption 4-channel EEG measurement system (NeuroVista) for frontal area EEG measurements, which can be used with a VR headset, enabling EEG measurements in VR environments. The system has an input-referred noise of less than 0.9480 μVrms, a common mode rejection ratio of over 96 dB, a measurement resolution of less than 0.1 μV, a bandwidth of 0.5 ∼ 45 Hz, and works at a sampling rate of 250 Hz. It also supports metal dry electrodes and includes a built-in analog bandpass filter, right-leg drive circuit, and built-in digital lowpass filter and notch filter, which can reduce noise during measurement. Researchers can reconstruct the electrode system to measure regions of interest according to their needs.

Interactive Virtual Ankle Movement Controlled by Wrist sEMG Improves Motor Imagery: An Exploratory Study.

Virtual reality (VR) techniques can significantly enhance motor imagery training by creating a strong illusion of action for central sensory stimulation. In this study, we establish a precedent by using surface electromyography (sEMG) of contralateral wrist movement to trigger virtual ankle movement through an improved data-driven approach with a continuous sEMG signal for fast and accurate intention recognition. Our developed VR interactive system can provide feedback training for stroke patients in the early stages, even if there is no active ankle movement. Our objectives are to evaluate: 1) the effects of VR immersion mode on body illusion, kinesthetic illusion, and motor imagery performance in stroke patients; 2) the effects of motivation and attention when utilizing wrist sEMG as a trigger signal for virtual ankle motion; 3) the acute effects on motor function in stroke patients. Through a series of well-designed experiments, we have found that, compared to the 2D condition, VR significantly increases the degree of kinesthetic illusion and body ownership of the patients, and improves their motor imagery performance and motor memory. When compared to conditions without feedback, using contralateral wrist sEMG signals as trigger signals for virtual ankle movement enhances patients' sustained attention and motivation during repetitive tasks. Furthermore, the combination of VR and feedback has an acute impact on motor function. Our exploratory study suggests that the sEMG-based immersive virtual interactive feedback provides an effective option for active rehabilitation training for severe hemiplegia patients in the early stages, with great potential for clinical application.

Combining Virtual Reality with Mixed Reality for Efficient Training in Battery Manufacturing

AbstractThe manufacturing process of batteries can be complex and time‐consuming. We introduce a new version of the digital twin of our lithium‐ion battery pilot line, Simubat 4.0 Gen‐2, based on a new combination of Virtual Reality and Mixed Reality. This digital twin is designed to deliver training on the lithium‐ion battery manufacturing process and electrode properties. This tool aims to make users active learners, helping them visualize and understand complex concepts and meets a strong need for skilled labor linked to the blooming of battery gigafactory, in particular in our region. We report here a detailed study of the educational contribution of Simubat 4.0 Gen‐2. This study was performed during two filmed training sessions: the first one with chemistry MSc. students, and the second one with AESC Gigafactory trainees. We used questionnaires to measure the usability and usefulness and at the same time, we studied the usage by analyzing errors and qualitatively assessing communications among the participants. Our study revealed that users had more knowledge after using our digital twin; the tool was evaluated as being efficient by the users and it has been proven to be suitable for training in battery manufacturing.

Network meta-analysis of randomized controlled trials comparing the effectiveness of different treatments in reducing amniocentesis-associated pain and anxiety

ObjectiveThis network meta-analysis compared different methods to determine which is most efficient at lowering pain and anxiety in women undergoing amniocentesis.MethodWe looked through all published randomized controlled trials in the databases PubMed, Scopus, Web of Science, Cochrane, and EM base. Anxiety and pain were the predominant results. We used the R software version 4.2.1 to analyze the data.ResultsWe included a total of 20 studies, with sample sizes ranging from 60 to 570. Virtual reality was the most effective strategy for lowering pain during AC [MD = -1.30, 95% CI (-2.11, -0.49)]. In addition, paracetamol use was the most successful approach for lowering pain following AC [MD = -1.68, 95% CI (-1.99, -1.37)]. The use of H7 acupressure, however, was the strategy that significantly reduced anxiety following AC [SMD = -15.46, 95% CI (-17.77, -13.15)].ConclusionThe most effective method for reducing pain is the combination of virtual reality with paracetamol. Whereas, the most effective way to reduce anxiety is to combine an ice gel pack with H7 acupressure before applying AC.

Virtual reality aggression prevention treatment in a Dutch prison-based population: a pilot study.

Treating violent behavior in prisons comes with challenges, such as the inability to practice safely with triggering situations and motivational issues. A solution may be the use of Virtual Reality (VR). With VR, specific conditions or needs can be tailored for individual practice, it can enhance motivation and VR has proven to be a safe and effective tool in mental health treatment. A pilot study was conducted to test the acceptability, feasibility, and preliminary effects of VR Aggression Prevention Treatment (VRAPT) in a prison-based population. In total 17 detainees with aggressive behavior were included in this single-group pilot study. Acceptability and feasibility were assessed using qualitative measures for participants and therapists. Preliminary treatment effects were measured with self-report and observational measures on aggression, anger, emotion regulation, and impulsiveness. Participants and therapists were predominantly positive about VRAPT. Participants rated the sessions with an average satisfaction score of 9.2 out of 10 (SD = 0.3). Qualitative data showed that participants reported having learned to respond more adequately to aggressive behavior and gained insights into their own and others' triggers and tension. The combination of VR and theory was experienced as a strength of the treatment, as well as the ability to trigger aggression in VR which provided insights into aggression. However, the theoretical framework was found to be too complex, and more aggressive and personal scenarios should be incorporated into the sessions. Self-reported aggression, anger, provocation, emotion regulation, and observed verbal aggression decreased and seemed to stabilize after the treatment ended, with small to medium effect sizes. VRAPT proved feasible and acceptable for most participants and therapists. An adapted treatment protocol called Virtual Reality Treatment for Aggression Control (VR-TrAC), will be used in a future RCT to investigate the effects of the treatment in a prison-based population.

Combination of Virtual Reality (VR) and BCI & fMRI in Autism Spectrum Disorder

The combination of virtual reality and fMRI is an innovative methodology that is used to make inferences about the neurological stimulations that take place in the brain of the person with ASD during the use of the VR tool. At the same time, the use of the Brain-Computer Interface (BCI) will be important, as it can be used to achieve direct interaction between the person with ASD and the computer. Still, equally important conclusions can be arrived at through the EEG electroencephalogram, also establishing the neurological processes that are carried out during the use of the VR tool. The use of the two technologies mentioned above contributes to presenting in-depth conclusions and data about the emotional state experienced by children with ASD throughout the experimental process and their interaction with the virtual reality tool.

SP11.16 Development and Validation of a Novel Simulation-Based Assessment of Operative Skill for Higher Specialist Trainees in General Surgery

Abstract Introduction Simulation is an established training modality, though its use in high-stakes assessment is under-explored. This study sought to develop and validate a novel assessment of operative competence for higher specialist trainees in general surgery. Methods Content validity was derived from a previously conducted Delphi consensus study of trainers. Eight stations were created using a combination of virtual reality and bio-hybrid models. The assessment was designed to assess performance at the end of ‘phase 2’ of training. Performance was scored using an equally weighted Objective Structured Assessment of Technical Skills (OSATS) tool and a modified Procedure Based Assessment (PBA) tool. Validity evidence was analysed in accordance with Messick's validity framework. Both ‘junior’ (ST2 - ST4) and ‘senior’ trainees (ST 5 - ST8) were included to allow for comparative analysis. Results Thirteen trainees (six ‘junior’ trainees and seven ‘senior’ trainees) were observed and scored by a total of ten assessors across eight stations. Inter-station reliability was high (Cronbach's alpha 0.81). Inter-rater reliability was acceptable (inter-class correlation coefficient 0.77). A significant difference in mean station score was observed between junior and senior trainees (44.82 vs 58.18, p = .004). Mean scores were moderately correlated with increasing training year (rs = .74, p = .004, Kendall’s tau-b .57, p = 0.009). A pass-fail score generated using borderline regression methodology resulted in all ‘senior’ trainees passing and 4/6 (66.66%) of junior trainees failing the assessment. Conclusion This study demonstrates the validity, reliability and feasibility of a novel simulation-based assessment, designed to assess the operative competence of higher specialist trainees in general surgery.

A non-immersive virtual reality serious game application for flood safety training

Various methodologies and technologies have been developed and tested to train communities for natural hazards and investigate human behaviour. The combination of Virtual Reality (VR) and Serious Games (SG) represents a promising solution to expose communities to different hazardous scenarios in a totally safe way and without exposing the testers to any real risks. Previous studies tested VR SG for several different natural hazards and safety training scenarios, but only a few applications have been proposed within the context of flood safety training. Furthermore, comprehensive prototyping works aimed at evaluating VR SG applications in terms of knowledge acquisition, self-efficacy and user experience, are still needed.This work proposes a novel non-immersive VR SG in the context of users' safety in the event of flooding in the urban built environment, pursuing the users' safety training. The proposed application is based on several modules, which can be combined to form different storylines and training objectives. The VR SG capabilities are demonstrated here by firstly considering one significant storyline. Results show a significant increase in self-efficacy and safety knowledge after the VR experience, thus suggesting the possibility to exploit it for increasing users’ awareness and preparedness. Furthermore, results also demonstrate the existence of similarities between real-world behaviours and VR choices by the tested individuals, thus suggesting how an application of this kind could also be used to support the development and validation of flood evacuation simulators.

Virtual reality as a means to explore assistive technologies for the visually impaired.

Visual impairment represents a significant health and economic burden affecting 596 million globally. The incidence of visual impairment is expected to double by 2050 as our population ages. Independent navigation is challenging for persons with visual impairment, as they often rely on non-visual sensory signals to find the optimal route. In this context, electronic travel aids are promising solutions that can be used for obstacle detection and/or route guidance. However, electronic travel aids have limitations such as low uptake and limited training that restrict their widespread use. Here, we present a virtual reality platform for testing, refining, and training with electronic travel aids. We demonstrate the viability on an electronic travel aid developed in-house, consist of a wearable haptic feedback device. We designed an experiment in which participants donned the electronic travel aid and performed a virtual task while experiencing a simulation of three different visual impairments: age-related macular degeneration, diabetic retinopathy, and glaucoma. Our experiments indicate that our electronic travel aid significantly improves the completion time for all the three visual impairments and reduces the number of collisions for diabetic retinopathy and glaucoma. Overall, the combination of virtual reality and electronic travel aid may have a beneficial role on mobility rehabilitation of persons with visual impairment, by allowing early-phase testing of electronic travel aid prototypes in safe, realistic, and controllable settings.

Digital Forensic in A Virtual World; A Case of Metaverse and VR

Metaverse is a virtual space where users can interact with each other. It is a combination of virtual reality, augmented reality, and mixed reality. This evolving technology can offer many exciting opportunities that can be used for individuals and businesses. Although this technology has many advantages, people are misusing it for their benefit. Many cyberattacks are occurring in the metaverse world because it has various vulnerabilities and privacy issues. This paper explains four cyberattacks and a case scenario of each attack as it relates to the metaverse. Additionally, this study developed a metaverse forensic framework that can be used to investigate cyberattacks in the metaverse world. Furthermore, this study describes how forensic examiners can conduct a forensic investigation using state-of-the-art forensic solutions and tools. The developed framework can be used by forensic examiners, security researchers, as well as the general scientific community for the security of the metaverse.

The combination and application of virtual reality and artificial intelligence

In recent years, virtual reality technology has gradually entered the public's vision. The rapid development of virtual reality technology has caused a great impact on people's cognition. Artificial intelligence (AI) is also a cutting-edge modern technology that can greatly affect human life. The combination of virtual reality (VR) and artificial intelligence is also seen as a new research direction. Based on this situation. By comparing with traditional virtual reality technology, this paper analyses the necessity and development situation of the combination of AI and VR, and expounds the feasibility and importance of AI+VR. At the same time, it explains how artificial intelligence can enhance the fidelity and interactivity of virtual reality technology to a certain extent. In addition, it also studies how AI can help VR in solving the current difficulties faced by VR technology. In addition, it also summarizes the application status of AI+VR, and looks forward to the impact of artificial intelligence and virtual reality technology on our life.

Uses and Considerations for Cinematic Virtual Reality in Health Care.

Through the combination of virtual reality (VR) technology with techniques from theater, filmmaking, and gaming, individuals from the Game Research and Immersive Design Laboratory (GRID Lab) at Ohio University have developed an approach to train soft skills such as communication, problem-solving, teamwork, and interpersonal skills which shows great promise. The purpose of this article is to provide an overview of VR and cinematic-VR (cine-VR). This article serves as a preface to the VR research included in this special issue. In this article, we define VR, review key terminology, present a case study, and offer future directions. Prior research with cine-VR has demonstrated the effectiveness in improving provider attitudes and cultural self-efficacy. While cine-VR may differ from other types of VR applications, we have been able to leverage the strengths of cine-VR to create training programs which are user friendly and highly effective. Early projects on diabetes care and opioid use disorder were sufficiently successful that the team received additional funding to pursue series addressing elder abuse/neglect and intimate partner violence. Their work has gone beyond health care and is currently being leveraged for law enforcement training as well. While this article will explore Ohio University's approach to cine-VR training, details of their research including efficacy can be found in McCalla et al, Wardian et al, and Beverly et al. When produced correctly, cine-VR has the potential to become a mainstay component of training for soft skill applications across a multitude of industries.

Impact of anxiety and confidence in virtual reality‐mediated learning transferred to hands‐on tasks

AbstractBackgroundBenefited from advances in technology, virtual reality (VR) has been widely applied to learning content in operational training as well as hands‐on courses. However, most current studies tend to evaluate learning effectiveness in this application, and few were focused on how learners can be benefited from transferring the knowledge learned to real‐world field performance. Moreover, in application‐oriented hands‐on courses such as embedded electronic circuits, to our best knowledge, none were presented in interactive learning materials with the combination of VR and neither were the understanding of the changes in cognition, learning anxiety, and learning confidence during the learning process.Method and ObjectiveWe combine VR technology with hands‐on tasks to design a VR‐based embedded electronic circuit learning system. We conduct a quasi‐experiment to investigate differences in knowledge, comprehension, and application levels in different learning environments, and to assess learning performance, learning anxiety, and learning confidence levels when applying the knowledge learned to real‐world hands‐on tasks.ResultsGroups that receive VR‐mediated training exhibit superior knowledge, comprehension, and application levels. In addition, learners with higher levels of knowledge and application exhibit lower learning anxiety and higher learning confidence during practical application tasks.ConclusionsWe investigate the learning outcomes of learners on practical hands‐on tasks after VR‐mediated learning. To improve the learning experience and performance for learners in an embedded electronic circuit course, we discuss the learning performance in terms of the knowledge and concepts learned in the VR environment and transferred to the real world. The results show that learners achieve better cognitive levels in the learning process through the VR system described here. Better performance on hands‐on tasks was also obtained as well as low anxiety and high confidence levels.

Process Modelling of an Analytic Control Machine in Virtual Reality Platform

While the combination of virtual reality (VR), industrial internet of things (IIoT) and digital twin (DT) can promote the integration of the physical world (real) and the digital world (virtual), one of the most important challenges that companies face is the choice of architecture. This study intends to utilize VR, IIoT, DT advantages and to reduce some adverse effects the constituent processes produce when they are individually applied. This bridges the existing gap between the physical and digital machines to enable near real-time monitoring control of the manufacturing process. In the realization of this paradigm shift, we use of IIoT infrastructures by adopting a bi-directional communication protocol for conveyance of data and information between the physical and virtual models in hardware in the loop or software in loop configuration. This study takes into account user case industrial application for the formation of silica scale and methods of reducing its production. In systems operating above pH 8.5, magnesium silicate is very likely to form due to the presence of magnesium hydroxide Mg(OH)2 and silicate (SiO4)4− ions. In this research work, the developed platform (VR, IIoT and DT) is used to remotely monitor and control the process that prevents silica scale formation by maintaining an acidic solution (pH < 6.7). A supervisory control is achieved using VR whereby instructions and commands sent to the physical station for execution. The data collected is stored in a data lake and is used to find the PID controller trends for pH 4 dosing and gain actionable insights. Analysis of the data is done by utilization of visualization schemes, diagrams and infographics. Results show the achievement of near real-time control (correlation coefficient at 99.92%) of a cyber-physical machine using VR by the adoption of bi-directional communication between the physical and virtual models in an immersive environment.

Virtual reality and embodied learning for improving letter-sound knowledge and attentional control in preschool children: A study protocol

Previous studies have shown that many children struggle with the acquisition of literacy skills and that these problems can be observed since the earliest stages of literacy learning. Embodied learning has been highlighted as a way to enhance the acquisition of early literacy skills. In addition, the use of technologies has been suggested as way of improving attentional control and motivation, which ultimately can improve learning outcomes. However, the combination of Virtual Reality (VR) and embodied learning in preschool children is yet to be explored wherefore the idea to the VR PLAYMORE study emerged. The project is designed as a three-armed randomized controlled trial with 6-7-year-old children in the Copenhagen area of Denmark. Children will be allocated to either a: 1) VR group, 2) mirror group or 3) control group throughout a 2-week intervention period. The VR group and mirror group will perform activities designed with accordance to the embodied learning theory. However, the VR group will perform the activities while wearing VR headsets whereas the mirror group will perform the activities in front of a whole-body mirror without VR headsets. The control group will continue regular teaching activities without the research group interruption. This study protocol follows the SPIRIT guidelines. Outcome measurements will include testing of literacy skills and attentional control. The study will add new knowledge to the research field of embodied learning and the use of VR technology in a school setting with focus on reading- and spelling-related skills and attentional control since this combination is yet to be explored.

Virtual Reality for Awe and Imagination.

Empirical research has explored the potential of the emotion of awe to shape creativity, while theoretical work has sought to understand the link between this emotion and transformation in terms of imagining new possible worlds. This branch of study relies on the transformative potential of virtual reality (VR) to examine and invite cognitive and emotional components of transformative experiences (TEs) within the interdisciplinary model of Transformative Experience Design (TED) and the Appraisal-Tendency Framework (ATF). TED suggests using the epistemic and emotional affordances of interactive technologies, such as VR, to invite TEs. The ATF can provide insight into the nature of these affordances and their relationship. This line of research draws on empirical evidence of the awe-creativity link to broaden the discourse and consider the potential impact of this emotion on core beliefs about the world. The combination of VR with these theoretical and design-oriented approaches may enable a new generation of potentially transformative experiences that remind people that they can aspire to more and inspire them to work toward imagining and creating a new possible world.

Industry goes metaverse – the fusion of real and virtual industrial worlds exemplified by the wastewater industry

Abstract Meeting friends to go shopping, visit a concert or do some sports together – all this and more is now “virtually” possible in the Metaverse. Currently, the creative industries have made the most of the potential of virtual worlds. But the metaverse has no limits. The newly created dynamics raise the question of the extent to which the manufacturing industry can benefit from the potential of these virtual worlds. So far, augmented reality (AR) has been recognized as being useful to the manufacturing industry. The combination of virtual reality (VR) and augmented reality (AR) now unleashes new opportunities for industrial companies. For example, by making a virtual inspection of unmanned facilities possible. A project which has been put into practice by the Entsorgungsverband Saar (EVS) in cooperation with the August-Wilhelm Scheer Institute.

Virtual reality augments effectiveness of treadmill walking training in patients with walking and balance impairments: A systematic review and meta-analysis of randomized controlled trials

Objective To systematically summarize and examine current evidence regarding the combination of virtual reality and treadmill training in patients with walking and balance impairments. Data sources English language randomized controlled trials, participants with walking and balance impairments, intervention group used virtual reality and treadmill, control group only used treadmill with the same training frequency and number of sessions. Six bioscience and engineering databases were searched. Methods Two independent reviewers conducted study selection, data extraction, and quality assessment. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Results Sixteen randomized controlled trials including 829 participants were identified. Compared to treadmill-only training, virtual reality augmented treadmill training induced significantly faster walking (p < 0.001; standardized mean difference (SMD) = 0.55, 95%CI: 0.30 to 0.81), longer step length (p < 0.001; SMD = 0.74, 95%CI: 0.42 to 1.06), narrower step width (p = 0.03; SMD = −0.52, 95%CI: −0.97 to −0.06), longer single leg stance period (p = 0.003; SMD = 0.77, 95%CI: 0.27 to 1.27), better functional mobility (p = 0.003; SMD = −0.44, 95%CI: − 0.74 to −0.15), improved balance function (p = 0.04; SMD = 0.24, 95%CI: 0.01 to 0.47), and enhanced balance confidence (p = 0.03; SMD = 0.73, 95%CI: 0.08 to 1.37). Walking endurance did not differ significantly between groups (p = 0.21; SMD = 0.13, 95%CI: −0.07 to 0.34). Conclusions Virtual reality augmented treadmill walking training enhances outcomes compared to treadmill-only training in patients with walking and balance impairments. The results of this review support the clinical significance of combining virtual reality with treadmill training with level 1A empirical evidence.