Evaluating the effect of immersive virtual reality technology on gait rehabilitation in stroke patients: a study protocol for a randomized controlled trial

Abstract

Background The high incidence of cerebral apoplexy makes it one of the most important causes of adult disability. Gait disorder is one of the hallmark symptoms in the sequelae of cerebral apoplexy. The recovery of walking ability is critical for improving patients’ quality of life. Innovative virtual reality technology has been widely used in post-stroke rehabilitation, whose effectiveness and safety have been widely verified. To date, however, there are few studies evaluating the effect of immersive virtual reality on stroke-related gait rehabilitation. This study outlines the application of immersive VR-assisted rehabilitation for gait rehabilitation of stroke patients for comparative evaluation with traditional rehabilitation. Methods The study describes a prospective, randomized controlled clinical trial. Thirty-six stroke patients will be screened and enrolled as subjects within 1 month of initial stroke and randomized into two groups. The VRT group (n = 18) will receive VR-assisted training (30 min) 5 days/week for 3 weeks. The non-VRT group (n = 18) will receive functional gait rehabilitation training (30 min) 5 days/week for 3 weeks. The primary outcomes and secondary outcomes will be conducted before intervention, 3 weeks after intervention, and 6 months after intervention. The primary outcomes will include time “up & go” test (TUGT). The secondary outcomes will include MMT muscle strength grading standard (MMT), Fugal-Meyer scale (FMA), motor function assessment scale (MAS), improved Barthel index scale (ADL), step with maximum knee angle, total support time, step frequency, step length, pace, and stride length. Discussion Virtual reality is an innovative technology with broad applications, current and prospective. Immersive VR-assisted rehabilitation in patients with vivid treatment scenarios in the form of virtual games will stimulate patients’ interest through active participation. The feedback of VR games can also provide patients with performance awareness and effect feedback, which could be incentivizing. This study may reveal an improved method of stroke rehabilitation which can be helpful for clinical decision-making and future practice. Trial registration Chinese Clinical Trial Registry ChiCTR1900025375. Registered on 25 August 2019

A Virtual Reality Algorithm for the Study of Clinical Efficacy of Sports Injury Rehabilitation Training

“…Studies have shown that rehabilitation training supported by virtual reality is beneficial to task training, multisensory feedback, diversified rehabilitation tasks, and patients' enthusiasm [10]. Cai et al outlined the application of immersive virtual reality assisted rehabilitation technology in stroke patients' gait rehabilitation and compared it with traditional rehabilitation methods [11].…”

Virtual reality as a main basis for forming modern educational technologies

“…2) Security. In order to show how dangerous these or other situations are, we cannot subject students to certain tests, such as a fire or various kinds of natural disasters, and how to deal with them [4]. But with the use of virtual reality, it is possible for students to perform heart surgery, to control various techniques, for example, by train, to go on a space journey and even enter the Earth's orbit [5].…”

A Review of the Potential of Virtual Walking Techniques for Gait Rehabilitation

“…More recent reviews by Canning et al ( 2020 ), Huygelier et al ( 2021 ), and Keshner and Lamontagne ( 2021 ) highlighted the concrete contributions of VR to rehabilitation of balance and gait; suggesting that the most promising effects of VR are the ability to multitask in a VE that can replicate the demands of a physical space. There is indeed already a promising body of evidence for effective virtual walking techniques in populations such as stroke (Mirelman et al, 2010 ; Cai et al, 2021 ), multiple sclerosis (Samaraweera et al, 2013 ; Winter et al, 2021 ), Parkinson's disease (Janeh et al, 2019a ; Quek et al, 2021 ), and Alzheimer's disease (White and Moussavi, 2016 ). In this section, we summarize the different VR-based gait rehabilitation approaches:…”

“…Other researchers have used new technologies of locomotion devices, such as Strider (Freiwald et al, 2020 ), 360° VR video-based immersive cycling training system (Lee et al, 2021 ) and KatWalk omnidirectional treadmill (Cherni et al, 2021 ). In addition, a recent study by Cai et al ( 2021 ) has shown that WIP is feasible on gait rehabilitation of stroke patients, which translates the viewpoint when the user marches in a stationary location.…”