Application of a virtual reality tracker-based system to measure seated postural stability in stroke patients

Abstract

Background Postural stability while sitting is an important indicator of balance and an early predictor for future functional improvement in neurorehabilitation, but the evaluation is usually dependent on clinical balance function measures. Meanwhile, instrumental posturography has been used widely to obtain quantitative data and characterize balance abilities and underlying control mechanisms, but not as often for sitting balance. Moreover, traditional kinetic methods using a force platform to test sitting stability often require modification and are costly. We proposed a tracker-based posturography with a commercial virtual reality system, the VIVE Pro system (HTC, Inc. Taiwan), to record the trunk displacement (TD) path with a lumbar tracker for evaluation of sitting stability. The goals were to test the reliability and validity of the TD parameters among stroke patients. Methods Twenty-one stroke individuals and 21 healthy adults had their postural sway measured with this system under four sitting conditions, i.e., sitting on a solid surface or a soft surface, with eyes open or closed. The test–retest reliability of the TD parameters was evaluated with intraclass correlation coefficients in 22 participants. We also tested the discriminative validity of these parameters to discriminate between stroke and healthy controls, and among four sitting conditions. Furthermore, the TD parameters were correlated with the three balance function tests: the Berg Balance Scale (BBS), the Postural Assessment Scale for Stroke Patients (PASS) and the Function in Sitting Test (FIST). Results The results indicated that the TD parameters obtained by tracker-based posturography had mostly moderate to good reliability across the four conditions, with a few exceptions in the solid surface and eyes open tasks. The TD parameters could discriminate the postural stability between sitting on solid and soft surfaces. The stroke group had more seated postural sway than the control group, especially while sitting on a soft surface. In addition, velocity measures in the sagittal and frontal planes had moderate to high correlations with the PASS and BBS scores. Conclusions This tracker-based system is a cost-effective option for the clinical assessment of body stability for stroke patients in a seated position and shows acceptable reliability and validity.

A novel balance training approach: Biomechanical study of virtual reality-based skateboarding

“…Virtual reality (VR) technology allows users to interact with computer-generated environments in a simulated environment (Cipresso et al, 2018). In healthcare, VR has been used as a tool for rehabilitation and training, with the potential to improve motor function, cognitive function, and psychological wellbeing in individuals with various conditions, such as stroke, low back pain, and Parkinson's disease (Lheureux et al, 2020;Liang et al, 2022;Yalfani et al, 2022). The immersive nature of VR can increase adherence and motivation to training programs and lead to improved outcomes (Moon et al, 2021;Recenti et al, 2021).…”

Validity of an android device for assessing mobility in people with chronic stroke and hemiparesis: a cross-sectional study

“…Postural stability when standing has been frequently studied post-stroke using force platforms to measure the center of pressure (COP) trajectories [ 78 ]. In line with previous studies that have determined greater displacements of the COP in people with chronic stroke [ 79 , 80 ], our participating chronic stroke survivors also displayed higher values of COM displacement in the medial-lateral direction.…”

Discriminative Changes in Sitting and Standing Postural Steadiness in Patients With Chronic Low Back Pain

“…A head-mounted display was not used in this study. The details of the VIVE trackerbased posturography setup have been described previously in two validation tests for standing and sitting tasks [24], [25]. The displacement data from the lumbar tracker were used to represent the trunk displacements, with the aid of two trackers positioned on the feet to establish a coordinate for the recorded trajectories (Figure 1).…”

“…We have applied a tracker-based posturography to measure trunk sway with a tracker from a commercial virtual reality (VR) system (VIVE Pro, by HTC Inc., Taiwan) and documented the satisfactory reliability and validity of the posturographic parameters computed from the trunk displacement trajectories at the lumbar level (TD L ) in both sitting and standing [24], [25]. The trajectories recorded from this setup can be used as a surrogate measure of COM displacement [26].…”