Erasme University Hospital (Hôpital Universitaire de Bruxelles - H.U.B.)
Brussels, 1070, Belgium
NCT Number: NCT07409116
To determine the added value of integrating virtual reality therapy (VRT) based balance training into conventional therapy (CT) for improving balance and gait in subacute stroke patients, and to evaluate the usability and patient satisfaction associated with the VRT based intervention, stroke patients will be recruited in the Neurorehabilitation Department of Erasme University Hospital.
Patients will be randomized to a group performing only CT (CT group) and a group in which 20% of the daily CT was replaced by VRT involving standing balance exercises performed with an immersive headset (VRT group). Functional ambulation classification (FAC), gait speed and step length on 10 meters walking test (10MWT), walking distance on 2 minutes walking test (2MWT) and Berg Balance Scale (BBS) will be assessed at baseline (T0) and post-intervention (T1). Sensory reweighting in the VRT group will also be evaluated through the Sensory Organization Test (SOT) at T0 and T1. Usability of the VR system and patient satisfaction associated with virtual reality will be assessed at T1 in the VRT group through a questionary.
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Notify Me18 year and older
All sexes
Interventional
Not applicable
Brussels, 1070, Belgium
Outcomes :
Analyse the effects of a virtual reality balance rehabilitation programme added to conventional therapy on the balance and walking ability of stroke patients.
Analyse feedback from patients who have experienced virtual reality in terms of the usability of the system and patient satisfaction associated with virtual reality.
Participants :
Stroke patients will be recruited in the Neurorehabilitation Department of Erasme University Hospital. Inclusion criteria will be
Study design This study will be a pragmatic, randomized controlled trial conducted in routine clinical settings. Participants will be enrolled during their inpatient stay in the neurorehabilitation unit. Following enrolment, they will be randomly allocated to either the CT group (conventional therapy alone) or VRT group (CT + VRT program) using a computer-generated randomization procedure.
Virtual reality therapy The virtual reality system will consist of a fixed computer running Virtualis software (Virtualis, France) an HMD (HTC Vive, HTC, Taiwan) with a resolution of 2,160 × 1,200 pixels (Full HD), a horizontal field of view of 110◦ and a frame rate of 90 Hz, two portable controllers (Vive Controller, HTC, Taiwan) and two static force platforms designed to measure center of pressure (CoP) data synchronized with the immersive virtual environments. Each session will last 20 minutes and will be performed under therapist supervision The VR training will consist of different types of exercises: 1/ weight transfer exercises (e.g. skiing) 2/ scrolling exercises (e.g. scrolling in a tunnel); 3/ dual-task exercises (balance + fun upper limb exercises) and 4/ stability limit exercises.
Assessment Patients will be evaluated at two time points: at baseline (T0) and post-intervention (T1, after the two weeks intervention) using validated outcome measures. Functional Ambulation Classification (FAC) will be used to quantify the level of human assistance required for ambulation. Walking capacity will be assessed through the Two-Minute Walk Test (2MWT). Walking speed and stride length will be measured using the 10-meter walk test (10MWT). Postural stability will be evaluated using the Berg Balance Scale (BBS). In addition, participants assigned to the VRT group will undergo a virtual reality-based Sensory Organization Test (VR-SOT) to objectively assess postural control at T0 and T1, and they will be asked to complete a structured satisfaction questionnaire on VR at T1.
Statistical analysis Normality will be verified using the Shapiro-Wilk. For the the primary outcome analyses, a two-way repeated-measures ANOVA will be conducted to examine the group (CT vs. VRT), time (T0-T1) and group x time interaction.
Within the VRT group, changes in VR-SOT scores between T0 and T1 will be analyzed using the Wilcoxon signed-rank test with Holm-adjusted p values. Spearman correlation coefficients will be calculated to assess the relationships between changes in SOT scores and changes in functional outcomes.
Healthy volunteers accepted: No
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
Exclusion criteria
Conventional Therapy will focus on motor rehabilitation, individualized according to their specific functional needs (exercises for individual deficits and mainly comprised sit-to-stand transfers, balance exercises, walking independence exercises, ergocycle endurance exercises, and dual-task exercises)
The virtual reality system will consist of a fixed computer running Virtualis software (Virtualis, France) an HMD (HTC Vive, HTC, Taiwan) with a resolution of 2,160 × 1,200 pixels (Full HD), a horizontal field of view of 110◦ and a frame rate of 90 Hz, two portable controllers (Vive Controller, HTC, Taiwan) and two static force platforms designed to measure center of pressure (CoP) data synchronized with the immersive virtual environments. Each session will last 20 minutes and will be performed under therapist supervision The VR training will consist of different types of exercises: 1/ weight transfer exercises (e.g. skiing) 2/ scrolling exercises (e.g. scrolling in a tunnel); 3/ dual-task exercises (balance + fun upper limb exercises) and 4/ stability limit exercises.
Time frame: From enrollment to the end of treatment at 2 weeks
To address this objective, the Berg Balance Scale (0-56 points; higher scores indicate better balance) will be used to assess changes in functional balance performance from baseline to post-intervention.
Time frame: From enrollment to the end of treatment at 2 weeks
In the VRT group, the Sensory Organization Test will be used to characterize potential changes in sensory integration for balance (score from 0 to 100%, higher scores indicate better postural control), from baseline to post-intervention. This test
Time frame: 1 questionnaire at the end of treatment at 2 weeks
Patient-reported experience in the VRT group will be assessed at T1 using the Virtual Reality Training Satisfaction Questionnaire (8-item Likert Scale).
Each item is rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree).
The questionnaire evaluates perceived usability, emotional response, and overall acceptability of virtual reality as an adjunct to conventional rehabilitation.
Higher scores indicate greater satisfaction and acceptability.
Time frame: From enrollment to the end of treatment at 2 weeks
The Functional Ambulation Classification (0-5; higher scores indicate better functional ambulation) will assess changes in walking independence from baseline to post-intervention.
Time frame: From enrollment to the end of treatment at 2 weeks
The 2-Minute Walk Test measures the distance walked in meters within 2 minutes; higher distances indicate better walking endurance.
Time frame: From enrollment to the end of treatment at 2 weeks
The 10-Meter Walk Test evaluates gait speed in m/s over a 10-meter distance; higher speeds indicate better performance.
Erasme University Hospital
Other
Study of the Effects of a Virtual Reality Balance Training Programme on the Balance and Walking Ability of Stroke Patients
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