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Use of Virtual Reality to Enhance Balance and Ambulation in Chronic Stroke: A Double-Blind, Randomized Controlled Study

Kim, Joong Hwi PT, PhD; Jang, Sung Ho MD; Kim, Chung Sun PT, PhD; Jung, Ji Hee MD, MS; You, Joshua H. PT, PhD

American Journal of Physical Medicine & Rehabilitation: September 2009 - Volume 88 - Issue 9 - p 693-701
doi: 10.1097/PHM.0b013e3181b33350
Original Research Article: Stroke

Kim JH, Jang SH, Kim CS, Jung JH, You JH: Use of virtual reality to enhance balance and ambulation in chronic stroke: A double-blind, randomized controlled study.

Objective: To examine an additive effect of virtual reality on balance and gait function in patients with chronic hemiparetic stroke.

Design: Twenty-four adults with hemiparetic stroke were randomly assigned to either an experimental group (n = 12) or a control group. Both groups underwent conventional physical therapy, 40 mins a day, 4 days a week for 4 wks. The experimental group received an additional 30 mins of virtual reality therapy each session. Balance performance was determined by the Balance Performance Monitor and Berg Balance Scale tests. Gait performance was determined by the 10-m walking test and Modified Motor Assessment Scale, and spatiotemporal parameters were obtained using GAITRite. Analysis of variance and correlation statistics were performed at P < 0.05.

Results: In the balance test, the experimental group had improved Berg Balance Scale scores, balance and dynamic balance angles (ability to control weight shifting) compared with the controls (P < 0.05). In the gait performance test, the experimental group showed significant improvements in velocity, Modified Motor Assessment Scale scores, cadence, step time, step length, and stride length (P < 0.05). Improvement in dynamic balance angles was correlated with velocity and cadence (P < 0.01).

Conclusions: This study demonstrates that virtual reality has an augmented effect on balance and associated locomotor recovery in adults with hemiparetic stroke when added to conventional therapy.

From the Department of Physical Therapy (JHK), Kang Hospital, Bukgu, Daegu, Republic of Korea; Department of Physical Medicine and Rehabilitation (SHJ), College of Medicine, Yeungnam University, Namgu, Daegu, Republic of Korea; Department of Physical Therapy (CSK), College of Rehabilitation Science, Daegu University, Gyeongsan, Gyeongbuk, Republic of Korea; Department of Physical Therapy (JHJ, JHY), Graduate School of Rehabilitation Science, Yonsei University, Kangwon-do, Republic of Korea.

All correspondence and requests for reprints should be addressed to Joshua H. You, PT, PhD, Department of Physical Therapy, Graduate School of Rehabilitation Science, Yonsei University, Center for Health, Wellness, Fitness, Prevention, and Healing Across the Life Span, 234 Heoungup-Myon, MaeJi-Ri, Wonju City, Kangwon-Do, Republic of Korea.

Disclosures: None.

Copyright © 2009 Wolters Kluwer Health, Inc. All rights reserved.