A Prospective, Randomized Trial to Evaluate the Efficacy of Virtual Reality Treatment Versus Traditional Balance Treatment in Patients with Stroke

Abstract

Abstract:Recovery from stroke needs different time and speed in every case depending on the brain capacity of neural plasticity. Based on neurophysiological researches high repetition of practice is required to induce neuroplastic changes and functional recovery of motor deficits. However, data from earlier studies shows that stroke patients generally perform a very limited number of movement repetitions in traditional therapy sessions. Virtual Reality therapy was found to be beneficial in improving trunk, hand, upper and lower extremity functions. However, reviews found no definitive conclusions regarding balance. The present study focuses on evaluating the efficacy of Nintendo Wii™ on balance and gait functions of stroke patients. Twenty one hemiparetic stroke patients were randomly assigned to either control or therapy groups. Effectiveness was evaluated by Fugl-Meyer balance subtest, Functional Ambulation Categories (FAC), Romberg (R), sharpened Romberg (SR), one-legged stance (OLS), six-meter walking test (6MWT) and timed up and go test (TUG). The analysis revealed a significant effect of training with Nintendo Wii™ for FAC z = 0.0267, FMBS z = 0.0046, OLST2 z = 0.0068 and OLS1 z = 0.0067 (affected side). The control group demonstrated improvement in R (z = 0.0474) and SR (z = 0.0411). In both groups improvement was detected in functional mobility and 6MWT (control group z = 0.0069, Wii groupz = 0.0123). No significant differences were found between groups. Findings of the current study support that balance treatment with Nintendo Wii™ is similarly effective method to improve static balance and functional mobility when compared with conventional therapy.