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A preliminary study of dual-task training using virtual reality: influence on walking and balance in chronic poststroke survivors |
Fishbein P, Hutzler Y, Ratmansky M, Treger I, Dunsky A |
Journal of Stroke & Cerebrovascular Diseases 2019;Nov;28(11):104343 |
clinical trial |
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
BACKGROUND: Stroke is a leading cause of death and disability in the Western world, and leads to impaired balance and mobility. OBJECTIVE: To investigate the feasibility of using a Virtual Reality-based dual task of an upper extremity while treadmill walking, to improve gait and functional balance performance of chronic poststroke survivors. METHODS: Twenty-two individuals chronic poststroke participated in the study, and were divided into 2 groups (each group performing an 8-session exercise program): 11 participated in dual-task walking (DTW), and the other 11 participated in single-task treadmill walking (TMW). The study was a randomized controlled trial, with assessors blinded to the participants' allocated group. Measurements were conducted at pretest, post-test, and follow-up. Outcome measures included: the 10-m walking test (10 mW), Timed Up and Go (TUG), the Functional Reach Test (FRT), the Lateral Reach Test Left/Right (LRT-L/R); the Activities-specific Balance Confidence (ABC) scale, and the Berg Balance Scale (BBS). RESULTS: Improvements were observed in balance variables: BBS, FRT, LRT-L/R (p < 0.01) favoring the DTW group; in gait variables: 10 mW time, also favoring the DTW group (p < 0.05); and the ABC scale (p < 0.01). No changes for interaction were observed in the TUG. CONCLUSIONS: The results of this study demonstrate the potential of VR-based DTW to improve walking and balance in people after stroke; thus, it is suggested to combine training sessions that require the performance of multiple tasks at the same time.
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