Virtual reality-based training improves community ambulation in individuals with stroke: a randomized controlled trial. Improvement in balance using a virtual reality-based stepping exercise: a randomized controlled trial involving individuals with chronic stroke An innovative training program based on virtual reality and treadmill: effects on gait of persons with multiple sclerosis Effect of virtual reality training on walking distance and physical fitness in individuals with Parkinson's disease. Treadmill Training with Virtual Reality Improves Gait, Balance, and Muscle Strength in Children with Cerebral Palsy. Clinical usefulness of the virtual reality-based postural control training on the gait ability in patients with stroke Home-based virtual reality balance training and conventional balance training in Parkinson's disease: A randomized controlled trial. Immersive Virtual Reality to Improve Walking Abilities in Cerebral Palsy: A Pilot Study Effects of Training With a Robot-Virtual Reality System Compared With a Robot Alone on the Gait of Individuals After Stroke Virtual reality exercise intradialysis to improve physical function: A feasibility randomized trial Cognitive training on stroke patients via virtual reality-based serious games
This is a single blind r and omized controlled trial to examine the effect of virtual reality-based training on the community ambulation in individuals with stroke . Twenty subjects with stroke were assigned r and omly to either the control group ( n=9 ) or the experimental group ( n=11 ) . Subjects in the control group received the treadmill training . Subjects in the experimental group underwent the virtual reality-based treadmill training .  Walking speed , community walking time , walking ability question naire ( WAQ ) , and activities-specific balance confidence ( ABC ) scale were evaluated . Subjects in the experimental group improved significantly in walking speed , community walking time , and WAQ score at posttraining and 1-month follow-up periods . Their ABC score also significantly increased at posttraining but did not maintain at follow-up period . Regarding the between-group comparisons , the experimental group improved significantly more than control group in walking speed ( P=0.03 ) and community walking time ( P=0.04 ) at posttraining period and in WAQ score ( P=0.03 ) at follow-up period . Our results support the perceived benefits of gait training programs that incorporate virtual reality to augment the community ambulation of individuals with stroke Objective : To study the clinical effectiveness and the usability of a virtual reality-based intervention compared with conventional physical therapy in the balance recovery of individuals with chronic stroke . Design : R and omized controlled trial . Setting : Outpatient neurorehabilitation unit . Participants : A total of 20 individuals with chronic stroke . Interventions : The intervention consisted of 20 one-hour sessions , five sessions per week . The experimental group combined 30 minutes with the virtual reality-based intervention with 30 minutes of conventional training . The control group underwent one hour conventional therapy . Main measures : Balance performance was assessed at the beginning and at the end of the trial using the Berg Balance Scale , the balance and gait subscales of the Tinetti Performance-Oriented Mobility Assessment , the Brunel Balance Assessment , and the 10-m Walking Test . Subjective data of the virtual reality-based intervention were collected from the experimental group , with a feedback question naire at the end of the trial . Results : The results revealed a significant group-by-time interaction in the scores of the Berg Balance Scale ( p < 0.05 ) and in the 10-m Walking Test ( p < 0.05 ) . Post-hoc analyses showed greater improvement in the experimental group : 3.8 ±2.6 vs. 1.8 ±1.4 in the Berg Balance Scale , –1.9 ±1.6 seconds vs. 0.0 ±2.3 seconds in the 10-m Walking Test , and also in the number of participants who increased level in the Brunel Balance Assessment ( χ2 = 2.5 , p < 0.01 ) . Conclusions : Virtual reality interventions can be an effective re source to enhance the improvement of balance in individuals with chronic stroke Abstract Aim : In this single blind r and omized controlled trial , we examined the effect of a virtual reality-based training on gait of people with multiple sclerosis . Methods : Twenty-five individuals with multiple sclerosis with mild to moderate disability were r and omly assigned to either the control group ( n = 11 ) or the experimental group ( n = 14 ) . The subjects in the control group received treadmill training . Subjects in the experimental group received virtual reality based treadmill training .  Clinical measures and gait parameters were evaluated . Result : Subjects in both the groups significantly improved the walking endurance and speed , cadence and stride length , lower limb joint ranges of motion and powers , during single and dual task gait . Moreover , subjects in the experimental group also improved balance , as indicated by the results of the clinical motor tests ( p < 0.05 ) . Between-group comparisons revealed that the experimental group improved significantly more than control group in hip range of motion and hip generated power at terminal stance at post-training . Conclusion : Our results support the perceived benefits of training programs that incorporate virtual reality to improve gait measures in individuals with multiple sclerosis . Implication of rehabilitation Gait deficits are common in multiple sclerosis ( 85 % ) and worsen during dual task activities . Intensive and progressive treadmill training , with and without virtual reality , is effective on dual task gait in persons with multiple sclerosis . Virtual reality-based treadmill training requiring obstacle negotiation increases the range of motion and the power generated at the hip , consequently allowing longer stride length and , consequently , higher gait speed OBJECTIVE To evaluate the effects of gait training with virtual reality ( VR ) on walking distance and physical fitness in individuals with Parkinson 's Disease ( PD ) . METHODS Thirty-seven individuals with PD participated in this prospect i ve , r and omized , controlled clinical trial . They were r and omly allocated to a control group su bmi tted to conventional training ( n = 12 ) , a treadmill group su bmi tted to gait training on a treadmill ( n = 13 ) and a VR group su bmi tted to gait training using the XboxTM ( n = 12 ) . Clinical measures , gait variables and the Six-Minute Walk Test ( 6MWT ) were evaluated : pre-intervention , after one intervention session , post-intervention and follow up ( 30 days after intervention ) . RESULTS The VR and treadmill groups travelled longer distances on the 6MWT and had faster gait speed in comparison to the control group . The VR and treadmill groups demonstrated an increase in pre-6MWT HR . The VR group had more intense HR after the first session and throughout training , but these gains were not maintained at the follow-up . CONCLUSION The present findings demonstrate that gait training with a VR program is as effective as treadmill training with regard to gains in walking distance and improvements in temporal gait variables in individuals with PD Independent walking is an important goal of clinical and community-based rehabilitation for children with cerebral palsy ( CP ) .  Virtual reality-based rehabilitation therapy is effective in motivating children with CP . This study investigated the effects of treadmill training with virtual reality on gait , balance , muscular strength , and gross motor function in children with CP . Eighteen children with spastic CP were r and omly divided into the virtual reality treadmill training ( VRTT ) group ( 9 subjects , mean age , 10.2 years ) and treadmill training ( TT ) group ( 9 subjects , mean age , 9.4 years ) . The groups performed their respective programs as well as conventional physical therapy 3 times/week for 8 weeks . Muscle strength was assessed using a digitalized manual muscle tester . Gross motor function was assessed using the Gross Motor Functional Measure ( GMFM ) . Balance was assessed using the Pediatric Balance Scale ( PBS ) . Gait speed was assessed using the 10-meter walk test ( 10MWT ) , and gait endurance was assessed using the 2-minute walk test ( 2MWT ) . After training , gait and balance was improved in the VRTT compared to the TT group ( P < 0.05 ) . Muscular strength was significantly greater in the VRTT group than the TT group , except for right hamstring strength . The improvements in GMFM ( st and ing ) and PBS scores were greater in the VRTT group than the TT group ( P < 0.05 ) . Furthermore , the VRTT group showed the higher values of 10MWT and 2MWT compared to the TT group ( P < 0.05 ) . In conclusion , VRTT programs are effective for improving gait , balance , muscular strength , and gross motor function in children with CP This study is a single blind r and omized controlled trial to determine the effect of virtual reality-based postural control training on the gait ability in patients with chronic stroke . Sixteen subjects were r and omly assigned to either experimental group ( VR , n= 8) or control group ( CPT , n= 8) . Subjects in both groups received conventional physical therapy for 60 min per day , five days per week during a period of four weeks . Subjects in the VR group received additional augmented reality-based training for 30 min per day , three days per week during a period of four weeks . The subjects were evaluated one week before and after participating in a four week training and follow-up at one month post-training . Data derived from the gait analyses included spatiotemporal gait parameters , 10 meters walking test ( 10 mWT ) . In the gait parameters , subjects in the VR group showed significant improvement , except for cadence at post-training and follow-up within the experimental group . However , no obvious significant improvement was observed within the control group . In between group comparisons , the experimental group ( VR group ) showed significantly greater improvement only in stride length compared with the control group ( P < 0.05 ) , however , no significant difference was observed in other gait parameters . In conclusion , we demonstrate significant improvement in gait ability in chronic stroke patients who received virtual reality based postural control training . These findings suggest that virtual reality ( VR ) postural control training using real-time information may be a useful approach for enhancement of gait ability in patients with chronic stroke BACKGROUND / PURPOSE Virtual reality has the advantage to provide rich sensory feedbacks for training balance function . This study tested if the home-based virtual reality balance training is more effective than the conventional home balance training in improving balance , walking , and quality of life in patients with Parkinson 's disease ( PD ) . METHODS Twenty-three patients with idiopathic PD were recruited and underwent twelve 50-minute training sessions during the 6-week training period . The experimental group ( n = 11 ) was trained with a custom-made virtual reality balance training system , and the control group ( n = 12 ) was trained by a licensed physical therapist . Outcomes were measured at Week 0 ( pretest ) , Week 6 ( posttest ) , and Week 8 ( follow-up ) . The primary outcome was the Berg Balance Scale . The secondary outcomes included the Dynamic Gait Index , timed Up- and -Go test , Parkinson 's Disease Question naire , and the motor score of the Unified Parkinson 's Disease Rating Scale . RESULTS The experimental and control groups were comparable at pretest . After training , both groups performed better in the Berg Balance Scale , Dynamic Gait Index , timed Up- and -Go test , and Parkinson 's Disease Question naire at posttest and follow-up than at pretest . However , no significant differences were found between these two groups at posttest and follow-up . CONCLUSION This study did not find any difference between the effects of the home-based virtual reality balance training and conventional home balance training . The two training options were equally effective in improving balance , walking , and quality of life among community-dwelling patients with PD Immersive virtual reality ( IVR ) offers new possibilities to perform treatments in an ecological and interactive environment with multimodal online feedbacks . Sixteen school-aged children ( mean age 11 ± 2.4 years ) with Bilateral CP — diplegia , attending mainstream schools were recruited for a pilot study in a pre – post treatment experimental design . The intervention was focused on walking competences and endurance and performed by the Gait Real-time Analysis Interactive Lab ( GRAIL ) , an innovative treadmill platform based on IVR . The participants underwent eighteen therapy sessions in 4 weeks . Functional evaluations , instrumental measures including GAIT analysis and parental question naire were utilized to assess the treatment effects . Walking pattern ( stride length left and right side , respectively p = 0.001 and 0.003 ; walking speed p = 0.001 ) , endurance ( 6MWT , p = 0.026 ) , gross motor abilities ( GMFM-88 , p = 0.041 ) and most kinematic and kinetic parameters significantly improved after the intervention . The changes were mainly predicted by age and cognitive abilities . The effect could have been due to the possibility of IVR to foster integration of motor/perceptual competences beyond the training of the walking ability , giving a chance of improvement also to older and already treated children Background and Purpose — Training of the lower extremity ( LE ) using a robot coupled with virtual environments has shown to transfer to improved overground locomotion . The purpose of this study was to determine whether the transfer of training of LE movements to locomotion was greater using a virtual environment coupled with a robot or with the robot alone . Methods — A single , blind , r and omized clinical trial was conducted . Eighteen individuals poststroke participated in a 4-week training protocol . One group trained with the robot virtual reality ( VR ) system and the other group trained with the robot alone . Outcome measures were temporal features of gait measured in a laboratory setting and the community . Results — Greater changes in velocity and distance walked were demonstrated for the group trained with the robotic device coupled with the VR than training with the robot alone . Similarly , significantly greater improvements in the distance walked and number of steps taken in the community were measured for the group that trained with robot coupled with the VR . These differences were maintained at 3 months ’ follow-up . Conclusions — The study is the first to demonstrate that LE training of individuals with chronic hemiparesis using a robotic device coupled with VR improved walking ability in the laboratory and the community better than robot training alone OBJECTIVE The main objective of this investigation was to assess feasibility of conducting a future RCT with an intradialysis non-immersive virtual reality exercise intervention . The secondary aim was to explore the impact of either conventional or VR exercise on physical function . DESIGN Feasibility r and omized trial . PARTICIPANTS Eighteen subjects who participated in a 16-week intradialysis combined exercise program .  INTERVENTIONS The program lasted four additional weeks of either combined exercise or virtual reality exercise . MAIN OUTCOME MEASURES Physical function was measured through several reliable tests ( sit-to-st and -to-sit tests 10 and 60 , gait speed , one-leg heel-rise tests , and 6-minute walk test ) at baseline , after 16 weeks of intradialysis combined exercise and by the end of four additional weeks of exercise .  Adherence to the exercise programs was registered . RESULTS There was a significant time effect , so that physical function improved in both groups . By the end of the 20 weeks , function improved as measured through the sit-to-st and -to-sit tests 10 and 60 , gait speed , one-leg heel-rise left leg , and the 6-minute walk test . Changes that did not occur due to error in the test were seen after 20 weeks were achieved in the sit-to-st and -to-sit test 60 , gait speed , one-leg heel-rise test for the left leg , and 6-minute walking test . CONCLUSION Virtual reality was a feasible intervention . Both interventions improved physical function . Adherence was not significantly different between groups Abstract Purpose : Use of virtual reality environments in cognitive rehabilitation offers cost benefits and other advantages . In order to test the effectiveness of a virtual reality application for neuropsychological rehabilitation , a cognitive training program using virtual reality was applied to stroke patients . Methods : A virtual reality-based serious games application for cognitive training was developed , with attention and memory tasks consisting of daily life activities . Twenty stroke patients were r and omly assigned to two conditions : exposure to the intervention , and waiting list control . Results : The results showed significant improvements in attention and memory functions in the intervention group , but not in the controls . Conclusions : Overall findings provide further support for the use of VR cognitive training applications in neuropsychological rehabilitation . Implication s for Rehabilitation Improvements in memory and attention functions following a virtual reality-based serious games intervention . Training of daily-life activities using a virtual reality application .  Accessibility to training contents
CONCLUSIONS : This review provided evidence that walking training associated with virtual reality-based training was effective in increasing walking speed after stroke , and result ed in better results than non-virtual reality interventions
OBJECTIVE : To systematic ally review the available evidence on the efficacy of walking training associated with virtual reality-based training in patients with stroke .
The specific questions were : Is walking training associated with virtual reality-based training effective in increasing walking speed after stroke ?
Is this type of intervention more effective in increasing walking speed , than non-virtual reality-based walking interventions ?