Balance Training In Virtual Reality In Patients With Chronic Sequels Of Stroke: Effects On ICF Domains, Preliminary Data

Objectives: To compare the effect of balance training performed in Virtual Reality environment (VR) with conventional balance training on Body Functions, Activity Level and Participation level according to the International Classification of Functioning, Disability and Health (ICF) model in patients with chronic sequels of stroke. Study Design: A prospective, single-blind, parallel-group randomized clinical trial. Participants: Twenty-three patients with chronic sequels of stroke. Interventions: Fourteen sessions of balance training performed in VR by using Nintendo Wii Fit™ games (NWF), for Experimental Group (EG), or conventional balance training for Control Group (CG). Main outcome measures: The Lower limb subscale of the Fulg-Meyer Assessment (FMA-LE) as a measure of Body Function domain; the Balance Evaluation Systems Test (BESTest), as a measure of Activity domain; and the Stroke-Specific Quality of Life Scale (SS--QOL), as a measures of Participation domain according to ICF. All outcome measures were administered at baseline, 1-week and at a 2-month follow-up. Results: The ANOVA for repeated measure showed that there were statistical significant improvements in FMA-LE and BESTest scores after training, which were kept at 2-month follow-up, for EG only. There was not statistically significant improvement in Participation level for both groups. Conclusions: Balance training performed in VR by using NWF was more efficient than conventional balance training to improve the Body Function and Activity level in patients with chronic sequels of stroke.