Vestibular Rehabilitation Verses Virtual Reality on Dizziness, Balance and Gait in Subacute Stroke
Condition: Vestibular Rehabilitation
MeSH terms: Vertigo; Dizziness
Study type: Interventional

Summary: 
      There is paucity of literature in studying the comparative effects of Vestibular
      Rehabilitation and Virtual Reality. This study will determine the effects of these
      interventions on dizziness, balance and gait. This study will also deduce the role of
      vestibular rehabilitation and Virtual reality in subacute stroke patients
    

Detailed description: 
      Stroke is defined as rapidly developing clinical signs of focal disturbance of cerebral
      function that lasts more than 24 hours or leading to death. It arises from vascular causes
      such as cerebral infarction, intracerebral hemorrhage or subarachnoid hemorrhage. Stroke
      refers to any damage to the brain due to abnormality of blood supply. Stroke patients have
      difficulty in maintaining balance and postural control because they have asymmetric posture,
      abnormal body imbalance and difficulty in weight transfer.

      Balance is required to maintain posture, to respond to voluntary movements and react to
      external perturbations. Because of the balance disorders, compensatory movements occur in
      stroke patients which causes them to consume more energy compared to healthy subjects and
      causes the development of inefficient walking pattern.

      Gait function determines the degree of physical ability of post-stroke patients and their
      ability to perform independent mobility during activities of daily living (ADL). Stroke
      patients acquire compensatory abnormal walking pattern as a result of muscular weakness and
      inability to maintain balance.

      Virtual reality rehabilitation systems provide direct sensorial feedback to which a person
      can respond and interact with environment. VR environments are commonly used in treating,
      training, and rehabilitation of stroke patients. In virtual reality rehabilitation, the
      patient moves and performs predetermined tasks as if he is performing the actions in reality.

      According to a study conducted by Hyung Young Lee, Virtual reality-based training has been
      used as therapeutic intervention for functional recovery of stroke patients. It provides a
      variety of environments based on the requirements of patients that can be selected for
      recovery.

      According to a study conducted by Yurong Mao, Virtual reality balance training provides more
      realistic proprioceptive and visual input and improves balance and gait function effectively.
      Virtual reality balance games can be used as an effective tool to train patients with balance
      dysfunction.

      Literature describes Virtual Reality training is effective in improving dynamic balance
      control and preventing falls in subacute stroke patients. Virtual reality training provides
      stroke patients with planned and consistent exercises to improve balance and gait by giving
      visual feedback to directly adjust their wrong weight center and shift visually.

      Its reported that Vestibular rehabilitation is frequently used treatment for dizziness and
      balance problems. Vestibular Rehabilitation is a combination of different exercise components
      with an aim to improve gaze stability, balance and gait and facilitate somatosensory
      integration. It is used in treatment of stroke patients to improve dynamic balance by acting
      on the vestibular system, thus facilitating recovery.

      A study indicated that, the main components of vestibular rehabilitation are gaze
      stabilization exercises to help adapt the VOR function and balance exercises to retrain the
      vestibulospinal reflex function. Thus, simultaneously measuring changes in the VOR function
      and gait performance before and after intervention will provide valuable information for
      rehabilitation.

      Vestibular system plays a phase dependent role in gait and is active at certain points in the
      gait cycle including double support, changing direction, and step termination.

      VRT is patient dependent and progression of the exercises depends upon individual patient's
      sensorimotor, cognitive, and emotional aspects.
    

Intervention name(s): vestibular Training Group; Virtual Reality Group
Intervention type(s): Other; Other
Intervention description(s): this Group will receive vestibular Adaptation & Balance exercises; This Group will receive Virtual Reality Training by using exergaming.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Dizziness; balance; Subacute stroke