Virtual Reality Training for Stroke Recovery

Recruiting at 1 trial location

Overseen By Mukul Mukherjee, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Nebraska

Disqualifiers: Recurrent stroke, Hip fracture, Myocardial infarction, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: 1 day

120 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

The major problem in stroke survivors that is being addressed in this research project is walking asymmetry, i.e., difference between the legs during walking (e.g. steps on the more affected side are longer than the other). A potential solution to this problem is using new technology like virtual reality during walking training to make stroke survivors have a better sense of their asymmetry. A second problem that we aim to address in this study is whether asymmetry is accurately felt by the stroke survivors and how we can address it. Our ongoing work on the effects of virtual reality on learning new walking tasks in stroke survivors indicates that virtual reality maybe particularly important for those with walking asymmetry. In this study, we plan to recruit stroke survivors who have such asymmetries during walking and have them learn a new walking task in virtual reality. We will also test the stroke survivors to determine if there is a relationship between how well they learn the new task with their ability to feel asymmetry accurately.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your doctor.

Is virtual reality training safe for stroke recovery?

The research does not specifically address safety concerns, but virtual reality-based interventions are widely studied and used for stroke rehabilitation, suggesting they are generally considered safe for human use. ^{1 2 3 4 5}

How is Virtual Reality Augmented Gait Adaptation different from other stroke recovery treatments?

Virtual Reality Augmented Gait Adaptation is unique because it uses virtual reality technology to enhance motor function and walking ability in stroke patients by providing immersive and interactive feedback, which can improve motivation and performance compared to traditional rehabilitation methods. ^{1 2 3 4 6}

What data supports the effectiveness of the treatment Virtual Reality Augmented Gait Adaptation for stroke recovery?

Research shows that virtual reality (VR) can help improve motor function, balance, and walking ability in stroke patients. Studies have found that VR-assisted training can be as effective or even superior to conventional treatments for improving lower limb function and mobility in stroke recovery. ^{1 2 4 6 7}

Who Is on the Research Team?

Mukul Mukherjee, PhD

Principal Investigator

University of Nebraska

Are You a Good Fit for This Trial?

This trial is for adults over 21 who had a single stroke more than 3 months ago, can walk 10 meters without help, stand without support, and follow instructions (with a specific mental exam score). It's not for those with recurrent strokes, hip fractures, recent heart attacks, poor vision that isn't corrected to at least 20/40 or other conditions affecting walking like Parkinson's.

Inclusion Criteria

I have had a stroke in the upper part of my brain.

I had a stroke more than 3 months ago.

I can stand on my own without help or devices.

Exclusion Criteria

I have had a hip fracture.

I have had more than one stroke.

You have vision that is worse than 20/40 even with glasses or contacts.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo gait adaptation training using virtual reality on a split-belt treadmill

1 day

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Virtual Reality Augmented Gait Adaptation

Trial Overview The study tests if virtual reality can improve walking symmetry in stroke survivors. Participants will learn new walking tasks using VR technology. The research also examines the relationship between learning these tasks and the ability to perceive their own asymmetry accurately.

How Is the Trial Designed?

Group I: Stroke Symmetric VR Experimental Treatment 1 Intervention

In this experimental arm, stroke survivors who walk symmetrically will walk on a split-belt treadmill in a VR - virtual reality environment.

Group II: Stroke Asymmetric VR Experimental Treatment 1 Intervention

In this experimental arm, stroke survivors who walk asymmetrically will walk on a split-belt treadmill in a VR - virtual reality environment.

Group III: Stroke Symmetric Non-VR Active Control 1 Intervention

In this control arm, stroke survivors who walk symmetrically will walk on a split-belt treadmill in a non-virtual reality environment.

Group IV: Stroke Asymmetric Non-VR Active Control 1 Intervention

In this control arm, stroke survivors who walk asymmetrically will walk on a split-belt treadmill in a non-virtual reality environment.

Who Is Running the Clinical Trial?

University of Nebraska

Lead Sponsor

Trials

563

Recruited

1,147,000+

Published Research Related to This Trial

In a study of 60 patients recovering from ischemic stroke, the use of virtual reality rehabilitation significantly improved motor function in the lower extremities compared to standard rehabilitation methods, with notable improvements in NIHSS and RMI scores.

The virtual reality intervention, which involved stimulating the plantar surface and using animated movement demonstrations, showed that patients were more ready to achieve independent walking after 10 days of therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Motor rehabilitation of patients in the acute period of stroke using virtual reality technology]. Zakharov, AV., Khivintseva, EV., Chaplygin, SS., et al.[2021]

A systematic review of 87 studies involving 3540 stroke patients found that virtual reality (VR) interventions significantly improved upper- and lower-limb motor function, balance, gait, and daily functioning outcomes.

However, VR interventions did not show significant benefits for cognitive functions, indicating that while VR is effective for physical rehabilitation, its impact on cognitive recovery in stroke patients needs further research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality for limb motor function, balance, gait, cognition and daily function of stroke patients: A systematic review and meta-analysis. Zhang, B., Li, D., Liu, Y., et al.[2021]

In a study involving 54 stroke patients, virtual reality-assisted gait adaptation training significantly improved walking speed, obstacle avoidance, and balance compared to traditional overground training.

The results suggest that virtual reality training can enhance walking and static balance functions in stroke patients, potentially reducing their risk of falls.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effects of VR-assisted and Overground Gait Adaptation Training on Balance and Walking Ability in Stroke Patients. Wang, X., Qiu, J., Zhou, Y., et al.[2023]

Recent reviews of virtual reality (VR) rehabilitation for upper limb and gait recovery post-stroke indicate that VR can be more effective than standard care, based on eight upper limb and two gait studies that met high evidence standards.

The studies highlighted the importance of various factors such as hardware, software, and intervention methods in optimizing VR rehabilitation, suggesting that further research is needed to fill knowledge gaps and improve practical applications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual Reality for Sensorimotor Rehabilitation Post-Stroke: The Promise and Current State of the Field. Fluet, GG., Deutsch, JE.[2021]

In a study of 60 chronic stroke patients, virtual reality (VR) training combined with conventional physiotherapy significantly improved lower extremity functional status and balance compared to conventional physiotherapy alone.

The VR group showed greater improvements in the Fugl-Meyer Assessment-Lower Extremity and Berg Balance Scale scores, indicating that incorporating VR into rehabilitation programs can enhance treatment outcomes for stroke patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Is virtual reality training superior to conventional treatment in improving lower extremity motor function in chronic hemiplegic patients? Yaman, F., Akdeniz Leblebicier, M., Okur, İ., et al.[2022]

The study will involve 18 individuals with chronic stroke to compare the effects of three different types of augmented feedback on walking speed and motivation: simple visual feedback, basic virtual reality (VR), and VR exergames.

The research aims to fill a knowledge gap regarding how these different feedback methods influence rehabilitation outcomes, specifically focusing on improvements in walking speed and intrinsic motivation during recovery from stroke.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of different types of augmented feedback on intrinsic motivation and walking speed performance in post-stroke: A study protocol. Alhirsan, SM., Capó-Lugo, CE., Brown, DA.[2022]

A meta-analysis of 32 studies involving 809 individuals showed that virtual reality (VR) interventions significantly improve gait performance in stroke survivors compared to conventional therapy, with medium effect sizes for cadence, stride length, and gait speed.

The combination of VR with robot-assisted gait training further enhances gait speed, indicating that VR-based interventions can be an effective rehabilitation tool for improving mobility in individuals recovering from stroke.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality training enhances gait poststroke: a systematic review and meta-analysis. Ghai, S., Ghai, I., Lamontagne, A.[2022]

Citations

1. Russia (Federation) pubmed.ncbi.nlm.nih.gov

[Motor rehabilitation of patients in the acute period of stroke using virtual reality technology]. [2021]

2. England pubmed.ncbi.nlm.nih.gov

Virtual reality for limb motor function, balance, gait, cognition and daily function of stroke patients: A systematic review and meta-analysis. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

The Effects of VR-assisted and Overground Gait Adaptation Training on Balance and Walking Ability in Stroke Patients. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

Virtual Reality for Sensorimotor Rehabilitation Post-Stroke: The Promise and Current State of the Field. [2021]

5. Turkey pubmed.ncbi.nlm.nih.gov

Is virtual reality training superior to conventional treatment in improving lower extremity motor function in chronic hemiplegic patients? [2022]

6. Netherlands pubmed.ncbi.nlm.nih.gov

Effects of different types of augmented feedback on intrinsic motivation and walking speed performance in post-stroke: A study protocol. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Virtual reality training enhances gait poststroke: a systematic review and meta-analysis. [2022]