To provide an initial evaluation of the safety, feasibility, and efficacy of IVR-WS for people with stroke.
8 participants with stroke who were admitted to our hospital between March 2024 and August 2024 (mean age at admission: 64.8±12.2, an average of 73.1±31.2 days between the onset and the first day of IVR-WS) were enrolled in the present study. The type of stroke in the participants was cerebral hemorrhage in 3 cases and cerebral infarction in 5 cases. Participants were provided 60 minutes of conventional physical therapy per day after their admission to our hospital. From the time the participants’ ability reached a plateau state, we conducted a combination of 20 minutes of IVR-WS and 40 minutes of conventional physical therapy, and this combined training (1 session) was continued for 10 consecutive days. The IVR-WS operated with Meta Quest2 (Meta Platforms, USA) was a balance training in which the participants were required to shift the center-of-gravity and make steps repeatedly without holding the controller while attempting to touch the target which was displayed in the virtual space in front of them using their hand. As feedback, when the participants' hands touched the target, the color of the target is changed and the special sound is produced. In addition, the time that the participant could touch the target was displayed as a VR score. The targets were either static or dynamic, and the difficulty (easy, normal, or hard) became progressively more difficult as the participant's VR score improved. These training sessions were conducted while the participants were equipped with a body Weight-Supporting system to prevent falls, and the application for IVR-WS was created independently by Unity2021.3.1f1 (Unity Technologies, USA). Differences in the Berg Balance Scale (BBS) between before and after the IVR-WS were statistically examined.
Of the 8 participants, only one participant was discharged after 5 sessions, while the other 7 participants completed the scheduled 10 sessions. The average total score of the Simulator Sickness Questionnaire was 7.4 points, and no significant side effects from the IVR-WS procedure were reported. The Visual Analogue Scale for satisfaction was 75.0 points. Furthermore, BBS improved significantly by 5.7±5.3 points (p0.05).
This case series study demonstrated the safety and feasibility of IVR-WS combined with conventional physical therapy for people with stroke.
The IVR-WS might be one of the future treatment options for people with stroke, as it provides safe and effective balance training with an appropriate level of difficulty.
balance training
virtual reality
