The Effect of Virtual Reality Therapy on Balance and Knee Control in Stroke Patients

Study Overview
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Brief Summary
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The aim of study is to determine whether the Virtual Reality training applied in addition to the exercises given inside and outside the parallel bar is effective on balance, daily living activities and knee control in stroke patients. The hypotheses of the study are: Hypothesis 1: H0: Virtual reality training has no effect on balance in stroke patients. H1: Virtual reality training has an effect on balance in stroke patients. Hypothesis 2; H0: Virtual reality training has no effect on activities of daily living in stroke patients. H1: Virtual reality training has an effect on daily living activities in stroke patients. Hypothesis 3; H0: Virtual reality training has no effect on knee control in stroke patients. H1: Virtual reality training has an effect on knee control in stroke patients

Detailed Description
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In recent years, virtual reality systems are widely preferred technology-assisted rehabilitation methods due to the many advantages they provide in stroke rehabilitation. Virtual reality increases the quality of movement and functional capacity both by providing a sensory environment and by motor learning.

Official Title
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The Effect of Virtual Reality Therapy Applied in Addition to Conventional Balance Training on Balance and Knee Control in Stroke Patients

Conditions
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Chronic Stroke

Intervention / Treatment
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* Other: Virtual Reality Therapy
* Other: Conventional Rehabilitation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Being between the ages of 18-70 Having a stroke for the first time Patients who can stand and walk independently Exclusion Criteria: Having neglect syndrome Being bilaterally affected Botulinum toxin application in the last three months Having additional neurological diseases such as Parkinson's, multiple sclerosis

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Conventional Rehabilitation Group<br>In the conventional rehabilitation program, bed exercises, mat activities, balance exercises inside or outside the parallel bar and walking training will be given to the patients every weekday. | Other: Conventional Rehabilitation<br>* In the conventional rehabilitation program, bed exercises, mat activities, balance exercises inside or outside the parallel bar and walking training will be given to the patients every weekday.<br>|
| Experimental: Virtual Reality Therapy Group<br>The patients in this group will be able to play balance-based games with the Virtual Reality System for 20 minutes, 3 days a week, together with the conventional rehabilitation program. | Other: Virtual Reality Therapy<br>* Patients in this group will play balance-based games with the Virtual Reality System.<br>Other: Conventional Rehabilitation<br>* In the conventional rehabilitation program, bed exercises, mat activities, balance exercises inside or outside the parallel bar and walking training will be given to the patients every weekday.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Computerized Gait Assessment System (Zebris Rehawalk) | Participants will walk at a comfortable walking speed on the treadmill. During the walk, the walk will be recorded with the video camera system integrated into the device. With the help of the system, the knee hyperextension angle during walking will be calculated with the markers placed on the recorded video. | Baseline | 
| Computerized Gait Assessment System (Zebris Rehawalk) | Participants will walk at a comfortable walking speed on the treadmill. During the walk, the walk will be recorded with the video camera system integrated into the device. With the help of the system, the knee hyperextension angle during walking will be calculated with the markers placed on the recorded video. | 6.week (at the end of the training) | 
| Barthel Index | This scale consists of 10 items that evaluate nutrition, bathing, self-care, dressing, defecation control, urine control, going to the toilet, ability to move from bed to wheelchair, mobility status such as walking or being dependent on a wheelchair, and stair climbing functions. | Baseline | 
| Barthel Index | This scale consists of 10 items that evaluate nutrition, bathing, self-care, dressing, defecation control, urine control, going to the toilet, ability to move from bed to wheelchair, mobility status such as walking or being dependent on a wheelchair, and stair climbing functions. | 6.week (at the end of the training) | 
| Functional Reach Test | It is based on the principle of lifting the arm 90° upwards and reaching forward as far as possible while keeping the feet on the ground. 15 cm. and the risk of falling below 15 cm increases significantly, between 15 and 25 cm. indicates a moderate risk of falling. Values less than 25.4 cm indicate an increased risk of falling. | Baseline | 
| Functional Reach Test | It is based on the principle of lifting the arm 90° upwards and reaching forward as far as possible while keeping the feet on the ground. 15 cm. and the risk of falling below 15 cm increases significantly, between 15 and 25 cm. indicates a moderate risk of falling. Values less than 25.4 cm indicate an increased risk of falling. | 6.week (at the end of the training) | 
| Timed Up and Go Test | It is an objective, reliable and simple measure for assessing balance and functional mobility. It can also be used for assessment of fall risk. | Baseline | 
| Timed Up and Go Test | It is an objective, reliable and simple measure for assessing balance and functional mobility. It can also be used for assessment of fall risk. | 6.week (at the end of the training) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Virtual Reality, Stroke, Knee Hyperextension, Gait Analysis, Activities of Daily Living, Balance