Cox C1, Bolt D2, Rademacher C2, Palla A3, Villiger M4,5
1SRH Fachhochschule für Gesundheit, Gera, Germany, 2Zürcher Rehazentrum, Physiotherapy, Wald, Switzerland, 3Zürcher Rehazentrum, Neurologie, Wald, Switzerland, 4Spital Davos, Davos, Switzerland, 5THIM University of Applied Sciences, Landquart, Switzerland
Background: Stroke and other neurological disorders cause physical limitations leading to problems with activities in daily life. Key factors influencing successful rehabilitation and functional recovery after stroke include variety in training, intensive movement repetition and a motivating training environment. Technologies which can provide all these features, independent of the participant's location, may thus provide significant benefits for rehabilitation.
Purpose: This single-centre, randomized controlled trial compared two interventions in a parallel-group design. Subjects were included between April to December, 2017. We hypothesized that an interactive virtual reality (VR) training system, called YouKicker® (YK), improves motor functions in ambulant participants after stroke, and that the system is a motivating and enjoyable training alternative to a conventional training program.
Methods: While the intervention group completed a training regime with YK with a first-person view of virtual lower limbs, the control group participated in a personal training program daily, for up to four weeks. Before and after training, primary clinical outcomes were assessed: 30 Sit-To-Stand Test (30STS) for functional strength, Timed Up and Go (TUG) for mobility and Berg Balance Score (BBS) for balance, as well as questionnaires regarding motivation, fun and feasibility.
Results: After training, the 16 included subjects from the VR training group showed significant improvements in motor functions (30STS: p = .000, BBS: p = .001, TUG: p = .001). Furthermore, the system was perceived as more fun than the personal training program (p = .006) as well as less strenuous (p = .028).
Conclusion(s): Training with an interactive VR system improves motor function in ambulant participants after stroke and we believe the system to be feasible and safe to use in neurorehabilitation.
Implications: The interactive VR system, i.e. YK, enables stroke subjects to perform intensive, repetitive training in an engaging manner. In combination with its ease of use, YK matches the requirements for a rehabilitation tool to be in a rehabilitation setting and we suggest that it is worth considering the YK in a group setting as a promising rehabilitation tool to complement the often monotonous rehabilitation routine. Clinicians who currently have access to the YK system should be reassured that its use during the rehabilitation of ambulant stroke patients appears reasonable, considering the patient's goals, abilities, and preferences.
Keywords: Neurorehabilitation, stroke, motor function
Funding acknowledgements: Internationale Hochschule für Physiotherapie THIM van der Laan (Landquart) and Fachhochschule "SUPSI" Physiotherapie (Landquart).
Purpose: This single-centre, randomized controlled trial compared two interventions in a parallel-group design. Subjects were included between April to December, 2017. We hypothesized that an interactive virtual reality (VR) training system, called YouKicker® (YK), improves motor functions in ambulant participants after stroke, and that the system is a motivating and enjoyable training alternative to a conventional training program.
Methods: While the intervention group completed a training regime with YK with a first-person view of virtual lower limbs, the control group participated in a personal training program daily, for up to four weeks. Before and after training, primary clinical outcomes were assessed: 30 Sit-To-Stand Test (30STS) for functional strength, Timed Up and Go (TUG) for mobility and Berg Balance Score (BBS) for balance, as well as questionnaires regarding motivation, fun and feasibility.
Results: After training, the 16 included subjects from the VR training group showed significant improvements in motor functions (30STS: p = .000, BBS: p = .001, TUG: p = .001). Furthermore, the system was perceived as more fun than the personal training program (p = .006) as well as less strenuous (p = .028).
Conclusion(s): Training with an interactive VR system improves motor function in ambulant participants after stroke and we believe the system to be feasible and safe to use in neurorehabilitation.
Implications: The interactive VR system, i.e. YK, enables stroke subjects to perform intensive, repetitive training in an engaging manner. In combination with its ease of use, YK matches the requirements for a rehabilitation tool to be in a rehabilitation setting and we suggest that it is worth considering the YK in a group setting as a promising rehabilitation tool to complement the often monotonous rehabilitation routine. Clinicians who currently have access to the YK system should be reassured that its use during the rehabilitation of ambulant stroke patients appears reasonable, considering the patient's goals, abilities, and preferences.
Keywords: Neurorehabilitation, stroke, motor function
Funding acknowledgements: Internationale Hochschule für Physiotherapie THIM van der Laan (Landquart) and Fachhochschule "SUPSI" Physiotherapie (Landquart).
Topic: Neurology: stroke; Robotics & technology
Ethics approval required: Yes
Institution: Zürcher Rehazentrum Wald
Ethics committee: Kantonale Ethikkommission Zürich
Ethics number: PB2016-00545
All authors, affiliations and abstracts have been published as submitted.
