THE COMPARISON OF THE CAREN VIRTUAL REALITY SYSTEM-BASED PROTOCOL AND ROUTINE PHYSICAL THERAPY ON BALANCE AND POSTURAL CONTROL IN PATIENTS WITH STROKE: A RANDOMIZED CONTROLLED TRIAL
Main Article Content
Keywords
Stroke, Balance, Postural Control, Virtual Reality, Rehabilitation, Physical Therapy
Abstract
Background: Stroke is a leading cause of disability worldwide, with many survivors experiencing persistent balance and postural control impairments. Restoring balance function is crucial for regaining independence and improving quality of life. Virtual reality (VR) technology has emerged as a promising tool for stroke rehabilitation, offering interactive and immersive training environments.
Objective: This randomized controlled trial compared the effectiveness of the CAREN VR system-based protocol with routine physical therapy (PT) on balance and postural control in patients with stroke.
Methods: Sixty participants post-stroke were randomly assigned to either the VR intervention group (n=30) or the control group receiving PT (n=30). The intervention group received a 4-week VR training program focusing on balance skills. The control group received a standard 4-week PT program for balance rehabilitation. Balance and postural control were assessed at baseline, post-intervention, and follow-up using validated outcome measures.
Results: The VR group demonstrated significantly greater improvements in primary and secondary outcome measures (e.g., Berg Balance Scale score, Timed Up and Go test results) compared to the PT group, both immediately after the intervention and at follow-up.
Conclusion: CAREN VR system-based training proved effective in improving balance function in stroke patients compared to traditional PT. VR may offer a valuable tool for stroke rehabilitation, promoting functional independence and enhancing quality of life. Further research is needed to explore long-term benefits, cost-effectiveness, and optimal VR training protocols.
References
2. Makki ARK, Tahir M, Amin U, Tabassum MMB, Kamran M, Tahir F. Mechanism of Meniscal Injury and its Impact on Performance in Athletes: Meniscal Injury in Athletes. The Healer Journal of Physiotherapy and Rehabilitation Sciences. 2022;2(3):232-7.
3. Tahir A, Fatima A, Khan MT. Association of depression in patients with fibromyalgia syndrome. Pakistan Journal of Rehabilitation. 2022;11(1):174-83.
4. Asghar M, Safdar Z, Tahir M. Quality of life and functional Outcomes among Burn Patients: A Cross Sectional Survey. Journal of Health and Rehabilitation Research. 2023;3(2):293-8.
5. Justice D, Chang KW-C, Rasmussen LT, Yang LJ. Neuromuscular Electrical Stimulation for Infants with Neonatal Brachial Plexus Palsy: A Pilot Study. The Open Journal of Occupational Therapy. 2023;11(2):1-13.
6. Safdar Z, Asghar M, Tahir M. Level of Quality of Life among Post Stroke Patients; A Cross Sectional Survey. Journal of Health and Rehabilitation Research. 2023;3(2):299-304.
7. Tahir M, Maqsood M, Azhar N, Safdar Z, Amin U, Waheed TS. Association of Knee Pain in Long Standing and Sitting among University Teachers: Association of Knee Pain in University Teachers. The Healer Journal of Physiotherapy and Rehabilitation Sciences. 2023;3(1):314-21.
8. Tahir M, Tariq F, Saeed HW, Nauman M, Usman M, Ali S. Impact of Air Pollution on Respiratory Health of Traffic Wardens in Lahore: Air Pollution and Respiratory Health. The Healer Journal of Physiotherapy and Rehabilitation Sciences. 2023;3(7):703-9.
9. Tahir M, Tehzeeb K, Javaid F, Khan UA, Ayyaz A, Usama M. EFFECTS OF ROUTINE PHYSICAL THERAPY WITH AND WITHOUT HIGH INTENSITY INTERVAL TRAINING ON BALANCE, QUALITY OF LIFE AND FUNCTION IN PARKINSON’S DISEASE PATIENTS. Journal of Population Therapeutics and Clinical Pharmacology. 2023;30(19):483-90.
10. Hussain MA, Sajid M, Hafeez S, Sarfraz M, Rashid R, Riaz A, et al. RELATIONS OF COLORECTAL CANCER WITH GENDER, AGE AND LIFESTYLE DIFFERENCE OVER AGE 45 YEARS SCREENED BY COLONOSCOPY IN LAHORE FROM 2022-2023. Journal of Population Therapeutics and Clinical Pharmacology. 2024;31(1):1328-38.
11. Omer A, Moghadam BA, Shadmehr A, Hafeez T, Azfar H, Arif M, et al. Effects of Kinesio Taping and Modified Constraint-Induced Movement Therapy on Upper Extremity Function, Quality of Life, and Spasticity in Individuals Recovering from Stroke. Journal of Health and Rehabilitation Research. 2024;4(1):167-72.
12. Manzari L, Perez-Fernandez N, Tramontano M. GAZE AND POSTURAL STABILITY
REHABILITATION.
13. Aardema F, Côté S, O’Connor K. Effects of virtual reality on presence and dissociative experience. Cyberpsychol Behav. 2006; 9:653.
14. Peruzzi A, Cappello A, Della Croce U, Mirelman A. Training and assessment of patients with neurological impairments using virtual reality, augmented feedback, inertial sensing and low cost video technology. PhD in Bioengineering. Alma Mater Studiorum-Universita di Bologna, XXV cycle. 2013; 85:86.
15. Forrester LW, Roy A, Krywonis A, Kehs G, Krebs HI, Macko RF. Modular ankle robotics training in early subacute stroke: a randomized controlled pilot study. Neurorehabilitation and neural repair. 2014;28(7):678-87.
16. Pereira EM, Rueda FM, Diego IA, De La Cuerda RC, De Mauro A, Page JM. Use of virtual reality systems as proprioception method in cerebral palsy: clinical practice guideline. Neurología (english edition). 2014;29(9):550-9.
17. Ang KK, Chua KSG, Phua KS, Wang C, Chin ZY, Kuah CWK, et al. A randomized controlled trial of EEG-based motor imagery brain-computer interface robotic rehabilitation for stroke. Clinical EEG and neuroscience. 2015;46(4):310-20.
18. McEwen D. Virtual Reality as a Clinical Modality For Retraining Balance and Mobility: Université d'Ottawa/University of Ottawa; 2017.
19. Kern F, Winter C, Gall D, Käthner I, Pauli P, Latoschik ME, editors. Immersive virtual reality and gamification within procedurally generated environments to increase motivation during gait rehabilitation. 2019 IEEE Conference on Virtual Reality and 3D User Interfaces (VR); 2019: IEEE.
20. AMBULATION IDTCD. World Congress and Annual Meeting of the Association of Academic Physiatrists. American journal of physical medicine & rehabilitation. 2020;99(3).
21. Fong J, Ocampo R, Tavakoli M. Intelligent robotics and immersive displays for enhancing haptic interaction in physical rehabilitation environments. Haptic interfaces for accessibility, health, and enhanced quality of life. 2020:265-97.
22. Amiri Z, Sekhavat YA, Goljaryan S. StepAR: A personalized exergame for people with multiple sclerosis based on video-mapping. Entertainment Computing. 2022; 42:100487.
23. Cai Y, Qian X, Li Q, Lin F, Huang M-C. Closed-looped sensing and stimulation system for Parkinson’s disease early diagnosis and rehabilitation. Smart Health. 2022; 26:100338.
24. MILEWSKA-JĘDRZEJCZAK M, BEDNARSKI I, SZPAKOWSKI P. Towards Effective Telerehabilitation: Assessing Effects of Applying Augmented Reality in Remote Rehabilitation of Patients Suffering from Multiple Sclerosis. Accessible Computing. 2022;15(4).
25. Sun Y. Virtual and Augmented Reality-Based Assistive Interfaces for Upper-limb Prosthesis Control and Rehabilitation. arXiv preprint arXiv:220502227. 2022.
26. Weber A. Virtual reality obstacle crossing: adaptation, retention and transfer to the physical world: London South Bank University; 2023.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Maheen Bashir
Theoretical and Applied Neuroscience University of Camerino, Italy.
Aamna Hassan
MS-PT (Pediatrics), Senior Lecturer, Agile Institute of Rehabilitation Sciences, Bahawalpur – Pakistan
Wajeeha Bakhat
MSNPT, Consultant Neurological Physiotherapist/Lecturer, Gulab Devi Institute of Physiotherapy Gulab Devi Educational Complex, Lahore – Pakistan
Madiha Tariq
DPT, MS (Paeds), CEO Madiha's Medcare, Paediatric Neurorehabilitation Specialist at Farooq Hospital, Lahore – Pakistan
Muhammad Sharyar
Sr. Lecturer, ZCRS, Ziauddin University, Karachi – Pakistan, ORCID : 0009-0007-4457-2560
Amina Saeed
DPT, University of Management and Technology, Lahore, Doctor of Physical Therapy, University Medical Centre, Lahore – Pakistan
Muhammad Tahir
Doctor of Physical Therapy, Link Medical Institute, Lahore – Pakistan
Umar Farooq
Doctor of Physical Therapy, Link Medical Institute, Lahore – Pakistan.