2.2. Intervention
dizziness, headache
This study lasted 6 weeks. Both groups received a 1-h neurological physiotherapy session 5 times a week, but the EG additionally received 3 sessions of VR per week. This pattern of 3 VR sessions per week was previously described and used by Cho et al. [The neurological physiotherapy sessions consisted of upper and lower limb strengthening exercises, resistance exercises, active and active-assisted kinesitherapy, anti-resistance exercises, aerobic exercises, simple and obstacle parallel bar gait, jumping gait, skill circuits with different tasks and different surfaces, stable and unstable, work on trellises, fine motor skill exercises in both limbs and weight transfer exercises to improve balance and postural stability. The exercises were performed in different positions, including standing, sedentary, quadrupedia, supine and prone depending on the condition of each patient.The VR program applied was an immersive VR by means of VR glasses (Oculus Quest 2), a computer (with the software), a camera (Kinect 360 v1) used as a sensor of the patient’s movements and a router that acted as a connection point between the glasses and the computer (For the generation of the virtual environment, a specific software called “Blexer “ was used, which was created with the idea of being a rehabilitation tool for physiotherapists [“Phiby’s Adventure” has two different modes according to each patient’s laterality. The patient, thus, by means of their left or right arm, will have to direct the green character, called “Phiby”, to one of the following mini games: Chop the Wood (chopping movement), Row the Boat (performing rowing movements) or Climb the Tree (simulating the movement of climbing up a tree) (To complete all the mini games, patients had to achieve a target of logs cut, meters rowed or meters climbed within a time limit. An interesting aspect of this software is that both the objectives and the time limit can be set according to the criteria of the physiotherapist prior to the exercise, depending on the ability of each patient, so that it is not the patient who adapts to the game: it is the game that adapts to each patient’s situation.Initially, a first contact session is carried out, with a time limit set at 180 s and a target of 40 logs cut, 40 m rowed and 40 m climbed, so that the patient has time to delve into the environment and perform the test.Both the calibration and the use of the mini games were performed in a standing position, with the physiotherapist behind the patient giving positive reinforcement and assisting the patient, if necessary, in each mini game. A chair was placed next to the patient as a safety measure, in case the patient suffers a headache, dizziness or needs to rest.The VR therapy was always applied after the neurological physiotherapy treatment.