Virtual reality to augment robot-assisted gait training in non-ambulatory patients with a subacute stroke: a pilot randomized controlled trial

Abstract Objective After stroke, people experience difficulties with walking that lead to restrictions in participation in daily life. The purpose of this study was to examine the effect of virtual reality gait training (VRT) compared to non-virtual reality gait training (non-VRT) on participation in community-living people after stroke. Methods In this assessor-blinded randomized controlled trial with 2 parallel groups, people were included between 2 weeks and 6 months after stroke and randomly assigned to the VRT group or non-VRT group. Participants assigned to the VRT group received training on the Gait Real-time Analysis Interactive Lab (GRAIL), and participants assigned to the non-VRT group received treadmill training and functional gait exercises without virtual reality. Both training interventions consisted of 12 30-minute sessions during 6 weeks. Primary outcome was participation measured with the restrictions subscale of the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P) 3 months postintervention. Secondary outcomes included subjective physical functioning, functional mobility, walking ability, dynamic balance, walking activity, fatigue, anxiety and depression, falls efficacy, and quality of life. Results Twenty-eight participants were randomized to the VRT group and 27 to the non-VRT group, of which 25 and 22 attended 75% or more of the training sessions, respectively. No significant differences between the groups were found over time for the USER-P restrictions subscale (1.23; 95% CI = −0.76 to 3.23) or secondary outcome measures. Patients’ experiences with VRT were positive, and no serious adverse events were related to the interventions. Conclusions The effect of VRT was not statistically different from non-VRT in improving participation in community-living people after stroke. Impact Although outcomes were not statistically different, treadmill-based VRT was a safe and well-tolerated intervention that was positively rated by people after stroke. VR training might, therefore, be a valuable addition to stroke rehabilitation.

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Hybrid Robot-Assisted Gait Training for Motor Function in Subacute Stroke: A Single-Blind Randomized Controlled Trial

10.21203/rs.3.rs-907900/v1 ◽

2021 ◽

Author(s):

Yen-Nung Lin ◽

Shih-Wei Huang ◽

Yi-Chun Kuan ◽

Hung-Chou Chen ◽

Wen-Shan Jian ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Lower Extremity ◽

Controlled Trial ◽

Gait Training ◽

The Novel ◽

Robot Assisted ◽

Randomized Controlled ◽

Subacute Stroke ◽

Before And After

Abstract Background:Robot-assisted gait training (RAGT) is a practical treatment adjunctive to conventional rehabilitation to provide high-intensity repetitive training for patients with stroke. The robot models designed are usually either the end-effector type or the exoskeleton type. We developed a novel hybrid RAGT system that combines the advantages of both types.Objective:This randomized controlled trial (RCT) evaluated whether the novel RAGT system was beneficial and assessed long-term effects (at the 3-month follow-up) for nonambulatory patients with subacute stroke.Methods:This trial recruited 40 patients with subacute stroke who were equally randomized to receive conventional rehabilitation or 15 add-on RAGT sessions. We assessed lower-extremity motor function, balance, and gait performance by using the following tools: active range of motion (AROM), manual muscle test (MMT), the Fugl-Meyer Assessment (FMA) lower-extremity subscale (FMA-LE) and total (FMA-total), Postural Assessment Scale for Stroke (PASS), Berg Balance Scale (BBS), Tinetti Performance Oriented Mobility Assessment (POMA) balance and gait subscores, and the 3- and 6-m walking speed and Timed Up and Go (TUG) tests. These measurements were performed before and after the intervention and at the 3-month follow-up.Results:Both groups demonstrated significant within-group changes in the AROM, MMT, FMA-LE, FMA-total, PASS, BBS, POMA, TUG, and 3- and 6-m walking speeds before and after intervention and at the 3-month follow-up (p < 0.05). Only FMA-LE (p = 0.014) and total (p = 0.002) scores differed significantly between groups (RAGT vs. control).Conclusion:Although the novel hybrid RAGT was beneficial, no powerful evidence to supported its effectiveness relative to the control group in substantial leg dysfunction after stroke.Trial Registration: The study was registered with an International Standard Randomized Controlled Trial Number, ISRCTN, ISRCTN15088682. Registered 16 September 2016, Retrospectively registered https://www.isrctn.com/ISRCTN15088682

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THE EFFECTS OF TREADMILL WALKING COMBINED WITH OBSTALCE-CROSSING ON WALKING ABILITY IN AMBULATORY PATIENTS AFTER STROKE: A PILOT RANDOMIZED CONTROLLED TRIAL

10.26226/morressier.58e389add462b802923854b6 ◽

2017 ◽

Author(s):

Jung-Wan Koo

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Treadmill Walking ◽

Walking Ability ◽

Randomized Controlled ◽

Ambulatory Patients ◽

Pilot Randomized Controlled Trial

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Virtual Reality-Based Cognitive Stimulation on People with Mild to Moderate Dementia due to Alzheimer’s Disease: A Pilot Randomized Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105290 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5290

Author(s):

Jorge Oliveira ◽

Pedro Gamito ◽

Teresa Souto ◽

Rita Conde ◽

Maria Ferreira ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Randomized Controlled Trial ◽

Virtual Reality ◽

Cognitive Function ◽

Controlled Trial ◽

Cognitive Stimulation ◽

Randomized Controlled ◽

Moderate Dementia ◽

Pilot Randomized Controlled Trial

The use of ecologically oriented approaches with virtual reality (VR) depicting instrumental activities of daily living (IADL) is a promising approach for interventions on acquired brain injuries. However, the results of such an approach on dementia caused by Alzheimer’s disease (AD) are still lacking. This research reports on a pilot randomized controlled trial that aimed to explore the effect of a cognitive stimulation reproducing several IADL in VR on people with mild-to-moderate dementia caused by AD. Patients were recruited from residential care homes of Santa Casa da Misericórdia da Amadora (SCMA), which is a relevant nonprofit social and healthcare provider in Portugal. This intervention lasted two months, with a total of 10 sessions (two sessions/week). A neuropsychological assessment was carried out at the baseline and follow-up using established neuropsychological instruments for assessing memory, attention, and executive functions. The sample consisted of 17 patients of both genders randomly assigned to the experimental and control groups. The preliminary results suggested an improvement in overall cognitive function in the experimental group, with an effect size corresponding to a large effect in global cognition, which suggests that this approach is effective for neurocognitive stimulation in older adults with dementia, contributing to maintaining cognitive function in AD.

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