Effects of Wearable Sensor Based Virtual Reality Game on Balance for Stroke
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      Pablo is a new virtual reality (VR) game combined with wearable motion sensor system which
      can targeted intervention in an interactive environment, immediate and sensitive feedback
      about the user's performance, a motivating effect due to game-based feature. Unlike
      commercial camera systems such as Kinect or force platforms, the systems require a continuous
      sightline or restrict the base of support which may increase risk of falling. Few of studies
      had investigated the rehabilitation effects on balance with Pablo for patients with stroke.
      The purpose of this study is to investigate the effects of virtual reality training through
      Pablo system in patients with chronic stroke.
    

Detailed description: 
      Pablo is a new virtual reality (VR) game combined with wearable motion sensor system which
      can targeted intervention in an interactive environment, immediate and sensitive feedback
      about the user's performance, a motivating effect due to game-based feature. Unlike
      commercial camera systems such as Kinect or force platforms, the systems require a continuous
      sightline or restrict the base of support which may increase risk of falling. Few of studies
      had investigated the rehabilitation effects on balance with Pablo for patients with stroke.

      PURPOSE: The purpose of this study is to investigate the effects of virtual reality training
      through Pablo system in patients with chronic stroke.

      METHODS: A prospective, randomized, controlled, blinded assessor design was used. Patients
      with stroke were recruited and randomly assigned to a "virtual reality(VR) group" (n = 20)
      and "functional balance training (FBT) group" (n = 20). After 18 training sessions (60
      minutes per session, 2 sessions per week), outcome measures which included the Berg Balance
      Scale, the Timed Up and Go Test (cognition), a gait analysis, the Activities-Specific Balance
      Confidence scale, Stroke Impact Scale (SIS), Level of pleasure, and frequency of adverse
      events. The data were analyzed using nonparametric tests, and significance was indicated at α
      < 0.05.
    

Intervention name(s): virtual reality treatment; standard treatment; balance training
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): 18 virtual reality training through Pablo system (30 minutes a time, 2-3 times a week). Postural transition included sit-to-stand, sit down, reaching to different directions, stepping to different directions with weight transfer, and bending the trunk forward and side to side. The controller was attached to lower extremity or trunk to control the game, such as elevator, hot air balloon, shooting cans, etc.; 18 standard rehabilitation sessions (60 minutes a time, 2-3 times a week). The rehabilitative protocol focus on strengthening, endurance training, ambulation, and ADL training that included: (1) Hip flexor and knee extensor strengthening with resistance progressing used by weight bag or Thera-band. (2) Cycle ergometer riding with increase speed and resistance. (3) Gait pattern and speed correcting through treadmill and parallel bar. (4) Hand functional training and strategy teaching for feeding, dressing, and toileting.; 18 balance training sessions (30 minutes a time, 2-3 times a week) (1) Facilitated the balance reaction through weight shifting exercise with standing on even surface to uneven surface, such as tilting board.(2) Postural transition included sit-to-stand, sit down, reaching to different directions, stepping to different directions with weight transfer, and bending the trunk forward and side to side. (3) Changed the standing requirement, such as single legged stance or lunge stance. (4) Increased perception complications through cognition or upper extremity task to improve dual task attention.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment