title: Feasibility of virtual reality augmented cycling for health promotion of people poststroke.
abstract: OBJECTIVE
  A virtual reality (VR) augmented cycling kit (VRACK) was developed to address motor control and fitness deficits of individuals with chronic stroke. In this article, we report on the safety, feasibility, and efficacy of using the VR augmented cycling kit to improve cardiorespiratory (CR) fitness of individuals in the chronic phase poststroke.
  
  
  METHODS
  Four individuals with chronic stroke (47-65 years old and ≥3 years poststroke), with residual lower extremity impairments (Fugl-Meyer 24-26/34), who were limited community ambulators (gait speed range 0.56-1.1 m/s) participated in this study. Safety was defined as the absence of adverse events. Feasibility was measured using attendance, total exercise time, and "involvement" measured with the presence questionnaire (PQ). Efficacy of CR fitness was evaluated using a submaximal bicycle ergometer test before and after an 8-week training program.
  
  
  RESULTS
  The intervention was safe and feasible with participants having 1 adverse event, 100% adherence, achieving between 90 and 125 minutes of cycling each week, and a mean PQ score of 39 (SD 3.3). There was a statistically significant (13%; P = 0.035) improvement in peak VO(2), with a range of 6% to 24.5%.
  
  
  CONCLUSIONS
  For these individuals, poststroke, VR augmented cycling, using their heart rate to set their avatar's speed, fostered training of sufficient duration and intensity to promote CR fitness. In addition, there was a transfer of training from the bicycle to walking endurance. VR augmented cycling may be an addition to the therapist's tools for concurrent training of mobility and health promotion of individuals poststroke.
authors.affiliation: Research in Virtual Environments and Rehabilitation Sciences Laboratory, Rutgers University, Camden, NJ, USA. judithedeutsch@rutgers.edu
authors.forename: Judith E
authors.initials: JE
authors.lastname: Deutsch
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Myslinski
authors.forename: Michal
authors.initials: M
authors.lastname: Kafri
authors.forename: Richard
authors.initials: R
authors.lastname: Ranky
authors.forename: Mark
authors.initials: M
authors.lastname: Sivak
authors.forename: Constantinos
authors.initials: C
authors.lastname: Mavroidis
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Lewis
mesh_terms: D000368:Aged; D001642:Bicycling / Q000502:physiology*; D005240:Feasibility Studies; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness / Q000502:physiology*; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D014584:User-Computer Interface