Background: With the emergence of virtual reality and interactive video gaming as a new approach in stroke rehabilitation, commercial gaming consoles have been adopted in many clinical settings due to their easy accessibility and low cost. However, evidence of the effectiveness of video gaming on balance training in stroke is limited. Objectives: 1) To evaluate the effectiveness of the virtual reality (VR) game system, Xbox360 Kinect, in balance training in patients with stroke. 2) To investigate the effectiveness of balance training with the game system in ambulation and functional capacity. Methodology: This was a randomized controlled pilot study. Fourteen subjects with stroke (mean age: 69.14 (plus or minus)2.73 years in virtual reality training (VRT) group; 68.86 (plus or minus)8.25 years in conventional physiotherapy training (CPT) group) were recruited from outpatient physiotherapy department in Hong Kong Buddhist Hospital. CPT group received conventional physiotherapy training while VRT group received balance training with VR game system in addition to conventional physiotherapy training. Both groups received 1-hour training twice a week for 6 weeks. Evaluations were performed at baseline and at the end of 6-week training. Primary outcome measures included Berg Balance Scale (BBS) and Sensory Organization Test (SOT) whereas secondary outcome measures included 10-meter walk test (10MWT) and Modified Barthel Index (MBI). Results: There was statistically significant improvement in BBS, SOT, 10MWT and MBI (p < 0.05) in both CPT and VRT group after 6-week training. For between-group comparison, significant difference was demonstrated only in SOT except the sub-test of standing on a stable surface with eyes open. Conclusion: This pilot study showed physiotherapy training with low cost VR game system is effective in improving the balance and functional capacity for persons with stroke.
Chow, R. T. K., Chan, A. C. M., & Tong, J. M. C. (2013). Effectiveness of virtual reality in balance training in stroke rehabilitation: A pilot study. Hong Kong Physiotherapy Journal, 31(2), 100. https://doi.org/10.1016/j.hkpj.2013.08.002