Deans' stroke musings: Effects of multi-sensory virtual reality training on gait adaptability and somatomotor network remodeling in patients with stroke: a randomized controlled trial

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, May 3, 2026

Effects of multi-sensory virtual reality training on gait adaptability and somatomotor network remodeling in patients with stroke: a randomized controlled trial

If our doctor/hospitals are so incompetent they can't get music therapy for survivors; virtual reality will never arrive at the hospital!

Effects of multi-sensory virtual reality training on gait adaptability and somatomotor network remodeling in patients with stroke: a randomized controlled trial

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Abstract

Objective

To investigate the effects of multisensory-integrated virtual reality (VR) training on gait adaptability and its regulatory mechanisms on the somatomotor network (SMN) in patients with stroke.

Methods

In this randomized controlled trial, 68 patients with stroke were allocated to a VR group (multisensory-integrated VR training) or a control group (conventional rehabilitation). Both groups received 30-minute sessions, 5 days/week for 4 weeks. The primary outcome was gait adaptability assessed by the Dynamic Gait Index (DGI). Secondary outcomes included the Timed Up and Go Test (TUGT), Berg Balance Scale (BBS), and Fugl-Meyer Assessment for Lower Extremity (FMA-LE). Functional near-infrared spectroscopy (fNIRS) measured resting-state functional connectivity within the SMN and task-evoked activation during stepping and obstacle crossing.

Results

The VR group showed significantly greater improvements than the control group in DGI total score (P = 0.010), TUGT (P = 0.005), and BBS (P < 0.001 ). fNIRS analysis revealed that the VR group exhibited significantly greater increases in task-evoked activation in the right posterior parietal cortex (PPC) and supplementary motor area (SMA) during stepping (P = 0.029 and P = 0.032, respectively), and in the right SMA during unaffected-limb obstacle crossing (P = 0.048). Resting-state functional connectivity analysis showed significantly enhanced connections within the SMN, including left SMA-right PPC and right PPC-left dorsolateral prefrontal cortex (DLPFC) (both P < 0.05). Correlation analyses revealed that increased right SMA activation during obstacle crossing was positively correlated with TUGT improvement (r = 0.590, P = 0.001), while enhanced right PPC-left DLPFC connectivity was positively correlated with DGI improvement (r = 0.403, P = 0.041).

Conclusion

Multisensory-integrated VR training was associated with improvements in gait adaptability and balance in patients with stroke. The underlying mechanisms may involve enhanced activation in the SMA and PPC, along with changes in functional connectivity within the SMN and between the SMN and cognitive control networks. However, given that the significant improvements in DGI, TUGT, and BBS were not sustained under the most conservative assumptions about missing data, these findings should be considered preliminary and warrant confirmation in studies with lower attrition rates.

Trial registration: Chinese Clinical Trial Registry, ChiCTR2500111919 (retrospectively registered). Registered 7 November 2025. Available from https//www.chictr.org.cn (registration number ChiCTR2500111919). Protocol The full trial protocol is available from the corresponding author upon reasonable request.