Sitting Balance Exercise Performed Using Virtual Reality Training on a Stroke Rehabilitation Inpatient Service: A Randomized Controlled Study

So failed research. 

Sitting Balance Exercise Performed Using Virtual Reality Training on a Stroke Rehabilitation Inpatient Service: A Randomized Controlled Study

Sheehy Lisa PhD

Taillon‐Hobson Anne MSc

Sveistrup Heidi PhD

Bilodeau Martin PhD

Yang Christine MD

Finestone Hillel MD

First published: 22 January 2020

https://doi.org/10.1002/pmrj.12331

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/pmrj.12331.

Abstract

Introduction

Virtual reality training (VRT) is engaging and may enhance rehabilitation intensity. Only one previous study has looked at its use to improve sitting balance after stroke.

Objective

To determine if supplemental sitting balance exercises, administered via VRT, improve control of sitting balance and upper extremity function in stroke rehabilitation inpatients.

Design

Assessor‐blinded, placebo‐controlled randomized controlled trial.

Setting

Stroke inpatient rehabilitation unit.

Participants

Seventy‐six participants (out of 130 approached) with sub‐acute stroke who could not stand independently were randomized to experimental and control groups. Sixty‐nine completed the study.

Interventions

The experimental group did VRT that required leaning and reaching, while the control group had their trunk restrained and performed VRT which only involved small upper extremity movements, to minimize trunk movement. Both groups performed 10‐12 sessions of 30‐45 minutes. Participants were assessed pre‐, post and one‐month post the sessions by a blinded examiner.

Outcome Measures

Function in Sitting Test (FIST, primary outcome measure); Ottawa Sitting Scale; Reaching Performance Scale; Wolf Motor Function Test (WMFT).

Results

Thirty‐three participants completed the experimental intervention and 36 the control. Pre/post differences for FIST were 3.4 [confidence interval (CI) 0.5;6.3] for the experimental group and 5.3 (2.9;7.7) for the control group. There was a significant improvement over time (adjusted for multiple comparisons, p<0.006) on most outcome measures excepting the WMFT Performance Time Scale (control group; p=0.007) and grip strength (p=0.008); there were no differences between groups (p>0.006).

Conclusions

Siting balance outcomes were similar for both groups; therefore this study does not support the use of sitting balance exercises provided via VRT for the rehabilitation of sitting balance after stroke. However, because it is only the second study to investigate VRT for sitting balance and upper extremity function, more research, using more challenging exercises and a greater treatment intensity, is required before definitive conclusions are made.
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