title: Effects of substituting a portion of standard physiotherapy time with virtual reality games among community-dwelling stroke survivors.
abstract: BACKGROUND
  Evidence indicates that the continuation of therapy among community-dwelling stroke survivors improves physical function. Community rehabilitation programmes often face limitations in terms of resources. It is imperative to include new motivational interventions to encourage some level of non-clinician management. The aim of this study was to determine whether there were any changes in physical function and activities of daily living when substituting a portion of the standard physiotherapy time with virtual reality games among community-dwelling stroke survivors.
  
  
  METHODS
  In this controlled trial, the experimental group received 30 minutes of virtual reality balance games in addition to 90 minutes of standard physiotherapy. The control group continued with their two hours of routine standard physiotherapy. Both groups received 12 therapy sessions: two-hour sessions twice per week for six continuous weeks. Changes in physical function, activities of daily living and balance ability were assessed using the Timed Up and Go test, 30-second Sit to Stand test, Timed Ten-Metre Walk test, Six-Minute Walk test and the Barthel Index, and static balance was assessed using a probalance board.
  
  
  RESULTS
  Twenty-eight participants completed post-intervention assessments. The results showed a significant within-subject effect on the Timed Up and Go test: F (1, 26) = 5.83, p = 0.02; and the 30-second Sit to Stand test; F (1, 26) = 13.50, p = 0.001. The between-subject effect was not significant (p > 0.05) for any of the outcome measurements.
  
  
  CONCLUSIONS
  Substituting a portion of the standard physiotherapy time with virtual reality games was equally effective in maintaining physical function outcomes and activities of daily living among community-dwelling stroke survivors.
  
  
  BACKGROUND
  Australia and New Zealand Clinical Trials Register, ACTRN12613000478718.
authors: Physiotherapy Programme, School of Rehabilitation Sciences, Faculty of Health Sciences, Jalan Raja Muda Aziz, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia. devinderkas@gmail.com.
authors: Devinder Kaur Ajit
authors: DK
authors: Singh
authors: Nor Azlin
authors: NA
authors: Mohd Nordin
authors: Noor Azah
authors: NA
authors: Abd Aziz
authors: Beng Kooi
authors: BK
authors: Lim
authors: Li Ching
authors: LC
authors: Soh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005260:Female; D005717:Games, Experimental; D006801:Humans; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D020521:Stroke / Q000453:epidemiology / Q000401:mortality; D000071939:Stroke Rehabilitation; D017741:Survivors; D016896:Treatment Outcome; D063367:Virtual Reality Exposure Therapy / Q000379:methods*; D016138:Walking