title: Improvement in balance using a virtual reality-based stepping exercise: a randomized controlled trial involving individuals with chronic stroke.
abstract: OBJECTIVE
  To study the clinical effectiveness and the usability of a virtual reality-based intervention compared with conventional physical therapy in the balance recovery of individuals with chronic stroke.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Outpatient neurorehabilitation unit.
  
  
  METHODS
  A total of 20 individuals with chronic stroke.
  
  
  METHODS
  The intervention consisted of 20 one-hour sessions, five sessions per week. The experimental group combined 30 minutes with the virtual reality-based intervention with 30 minutes of conventional training. The control group underwent one hour conventional therapy.
  
  
  METHODS
  Balance performance was assessed at the beginning and at the end of the trial using the Berg Balance Scale, the balance and gait subscales of the Tinetti Performance-Oriented Mobility Assessment, the Brunel Balance Assessment, and the 10-m Walking Test. Subjective data of the virtual reality-based intervention were collected from the experimental group, with a feedback questionnaire at the end of the trial.
  
  
  RESULTS
  The results revealed a significant group-by-time interaction in the scores of the Berg Balance Scale (p < 0.05) and in the 10-m Walking Test (p < 0.05). Post-hoc analyses showed greater improvement in the experimental group: 3.8 ±2.6 vs. 1.8 ±1.4 in the Berg Balance Scale, -1.9 ±1.6 seconds vs. 0.0 ±2.3 seconds in the 10-m Walking Test, and also in the number of participants who increased level in the Brunel Balance Assessment (χ(2) = 2.5, p < 0.01).
  
  
  CONCLUSIONS
  Virtual reality interventions can be an effective resource to enhance the improvement of balance in individuals with chronic stroke.
authors: Instituto Interuniversitario de Investigación en Bioingeniería y Tecnología Orientada al Ser Humano, Universitat Politècnica de València, Valencia, Spain Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales NISA, Fundación Hospitales NISA, Valencia, Spain rllorens@labhuman.com.
authors: Roberto
authors: R
authors: Lloréns
authors: Instituto Interuniversitario de Investigación en Bioingeniería y Tecnología Orientada al Ser Humano, Universitat Politècnica de València, Valencia, Spain.
authors: José-Antonio
authors: JA
authors: Gil-Gómez
authors: Instituto Interuniversitario de Investigación en Bioingeniería y Tecnología Orientada al Ser Humano, Universitat Politècnica de València, Valencia, Spain.
authors: Mariano
authors: M
authors: Alcañiz
authors: Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales NISA, Fundación Hospitales NISA, Valencia, Spain.
authors: Carolina
authors: C
authors: Colomer
authors: Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales NISA, Fundación Hospitales NISA, Valencia, Spain.
authors: Enrique
authors: E
authors: Noé
mesh_terms: D000704:Analysis of Variance; D002908:Chronic Disease; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D010045:Outpatients; D004856:Postural Balance / Q000502:physiology*; D012047:Rehabilitation Centers; D013030:Spain; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D063367:Virtual Reality Exposure Therapy / Q000379:methods*
keywords: Stroke; balance; postural control; virtual reality