Clinical Decision-Making and Virtual Reality Exercise

Study Overview
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Brief Summary
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Degenerative lumbar spine disease (DLSD) is common in elderly individuals and can result in pain, muscle weakness, and paresthesia. Numerous studies have reported that patients with DLSD usually have postural balance instability, which may affect the patient's gait, functional activities, and quality of life. The investigators propose to achieve the following aims: (1) to develop a clinical balance diagnostic tool to identify patients with DLSD who may require lumbar surgery (2) to investigate the effects of virtual reality skateboard exercise training on gait and balance in patients with DLSD.

Official Title
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Optimizing Clinical Decision-Making and Virtual Reality Exercise Training in Degenerative Lumbar Spine Disease

Conditions
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Degenerative Lumbar Spinal Stenosis, Degenerative Disc Disease, Degenerative Spondylolisthesis, Degenerative Intervertebral Discs

Intervention / Treatment
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* Other: VR skateboarding training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1) able to stand and walk for 5 minutes independently 2) aged between 50 and 80 years 3) received a diagnosis of DLSD based on imaging Exclusion Criteria: 1) previous lumbar surgery 2) neurological disorder such as stroke or spinal cord injury 3) metabolic disease such as diabetes mellitus 4) vestibular disease such as Meniere's disease.

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: VR skateboarding training<br>specific rehabilitation exercise for improving postural balance | Other: VR skateboarding training<br>* The virtual reality skateboard training (VR-skate) is used treadmill-based training. Virtual reality system is integrated into the split-belt treadmill for VR-skate. Participants slide the swing leg (sliding leg) along with the moving treadmill belt at a comfortable speed (same as walking speed).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postural balance | The postural balance measurements are performed by using a force platform. The data from the force platform is used to calculate the mean velocity (unit: cm/s), mean distance (unit: cm), mean frequency (unit: Hz), and 95% confidence ellipse area (unit: cm^2) | 1 year | 
| Functional assessment | Functional assessment is a process that allows for the identification of disability. The data from the functional assessment is used to calculate walking speed (unit: m/s), walking distance (unit: m), and duration (unit: s). | 1 year | 
| Muscle activities | Electromyography is a technique for evaluating and recording muscle activity. The data from electromyography is used to calculate a normalized value (unit: ratio). | 1 year | 
| Kinematic variables | A motion capture system is used to measure the joint kinematics. The data is used to calculate joint angles (unit: degree) and the displacement of the center of mass (unit: cm). | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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virtual reality, degenerative lumbar spine disease, rehabilitation, biomechanic, balance