Effects of community-based virtual reality treadmill training on balance ability in patients with chronic stroke.

[Purpose] We aimed to examine the effectiveness of a community-based virtual reality treadmill training (CVRTT) program on static balance abilities in patients with stroke. [Subjects and Methods] Patients (n = 20) who suffered a stroke at least 6 months prior to the study were recruited. All subjects underwent conventional physical therapy for 60 min/day, 5 days/week, for 4 weeks. Additionally, the CVRTT group underwent community-based virtual reality scene exposure combined with treadmill training for 30 min/day, 3 days/week, for 4 weeks, whereas the control group underwent conventional physical therapy, including muscle strengthening, balance training, and indoor and outdoor gait training, for 30 min/day, 3 days/week, for 4 weeks. Outcome measurements included the anteroposterior, mediolateral, and total postural sway path lengths and speed, which were recorded using the Balancia Software on a Wii Fit(™) balance board. [Results] The postural sway speed and anteroposterior and total postural sway path lengths were significantly decreased in the CVRTT group. Overall, the CVRTT group showed significantly greater improvement than the control group. [Conclusions] The present study results can be used to support the use of CVRTT for effectively improving balance in stroke patients. Moreover, we determined that a CVRTT program for stroke patients is both feasible and suitable.

Effects of combined fine motor skill and cognitive therapy to cognition, degree of dementia, depression, and activities of daily living in the elderly with Alzheimer's disease.

[Purpose] This study evaluated the effects of combined fine motor skill and cognitive therapies on cognition, depression, and activities of daily living in elderly patients with Alzheimer's disease (AD). [Subjects and Methods] Twenty-six participants comprised 2 groups. The experimental group (n=13) received combined fine motor skill and cognitive therapy, and the control group (n=13) received only general medical care. [Results] The experimental group showed improvements in cognition, degree of dementia, depression, and activities of daily living compared to the control group. However, there were no significant differences between the two groups. [Conclusion] These results suggest that combined fine motor skill and cognitive therapy improves cognition, degree of dementia, depression, and daily living in elderly patients with AD. These therapies would therefore be effective as general medical care strategies.

An ankle proprioceptive control program improves balance, gait ability of chronic stroke patients.

[Purpose] Balance and gait ability determine to a large degree the level of independence of daily living which is an important goal of rehabilitation. This study was conducted in order to examine the effectiveness of an ankle proprioceptive control program on ankle muscle strength, balance, and gait of chronic stroke patients. [Methods] Thirteen chronic stroke patients more than six months post-stroke were recruited. All subjects received ankle proprioceptive control training for 30 minutes per session, two days per week, over a period of six weeks. Outcome measures were ankle strength (BTE-Primus), the Timed Up and Go test (TUG), and spatiotemporal parameters measured by a GAITRite instrument. [Results] Significant improvements in ankle dorsiflexor strength, TUG, gait speed and cadence, step length, and stride length were observed on the paretic side. [Conclusion] The results of this study provide evidence in support of incorporation of an ankle proprioceptive control program for effective improvement of both balance and gait ability of chronic stroke patients. The findings of this study suggest the feasibility and suitability of an ankle proprioceptive control program for chronic stroke patients.

Clinical usefulness of the virtual reality-based postural control training on the gait ability in patients with stroke.

This study is a single blind randomized controlled trial to determine the effect of virtual reality-based postural control training on the gait ability in patients with chronic stroke. Sixteen subjects were randomly assigned to either experimental group (VR, n= 8) or control group (CPT, n= 8). Subjects in both groups received conventional physical therapy for 60 min per day, five days per week during a period of four weeks. Subjects in the VR group received additional augmented reality-based training for 30 min per day, three days per week during a period of four weeks. The subjects were evaluated one week before and after participating in a four week training and follow-up at one month post-training. Data derived from the gait analyses included spatiotemporal gait parameters, 10 meters walking test (10 mWT). In the gait parameters, subjects in the VR group showed significant improvement, except for cadence at post-training and follow-up within the experimental group. However, no obvious significant improvement was observed within the control group. In between group comparisons, the experimental group (VR group) showed significantly greater improvement only in stride length compared with the control group (P< 0.05), however, no significant difference was observed in other gait parameters. In conclusion, we demonstrate significant improvement in gait ability in chronic stroke patients who received virtual reality based postural control training. These findings suggest that virtual reality (VR) postural control training using real-time information may be a useful approach for enhancement of gait ability in patients with chronic stroke.