Clinical Experience Using a 5-Week Treadmill Training Program With Virtual Reality to Enhance Gait in an Ambulatory Physical Therapy Service

2014 ◽  
Vol 94 (9) ◽  
pp. 1319-1326 ◽  
Author(s):  
Shirley Roth Shema ◽  
Marina Brozgol ◽  
Moran Dorfman ◽  
Inbal Maidan ◽  
Lior Sharaby-Yeshayahu ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Physical Therapy ◽  
Training Program ◽  
Clinical Experience ◽  
Gait Training ◽  
Treadmill Training ◽  
Step Test ◽  
Control Group ◽  
Positive Effects ◽  
Clinical Records

BackgroundCurrent literature views safe gait as a complex task, relying on motor and cognitive resources. The use of virtual reality (VR) in gait training offers a multifactorial approach, showing positive effects on mobility, balance, and fall risk in elderly people and individuals with neurological disorders. This form of training has been described as a viable research tool; however, it has not been applied routinely in clinical practice. Recently, VR was used to develop an adjunct training method for use by physical therapists in an ambulatory clinical setting.ObjectiveThe aim of this article is to describe the initial clinical experience of applying a 5-week VR clinical service to improve gait and mobility in people with a history of falls, poor mobility, or postural instability.DesignA retrospective data analysis was conducted.MethodsThe clinical records of the first 60 patients who completed the VR gait training program were examined. Training was provided 3 times per week for 5 weeks, with each session lasting approximately 1 hour and consisting of walking on a treadmill while negotiating virtual obstacles. Main outcome measures were compared across time and included the Timed “Up & Go” Test (TUG), the Two-Minute Walk Test (2MWT), and the Four Square Step Test (FSST).ResultsAfter 5 weeks of training, time to complete the TUG decreased by 10.3%, the distance walked during the 2MWT increased by 9.5%, and performance on the FSST improved by 13%.LimitationsLimitations of the study include the use of a retrospective analysis with no control group and the lack of objective cognitive assessment.ConclusionsTreadmill training with VR appears to be an effective and practical tool that can be applied in an outpatient physical therapy clinic. This training apparently leads to improvements in gait, mobility, and postural control. It, perhaps, also may augment cognitive and functional aspects.

scholarly journals Effects of virtual reality-based treadmill training on the balance and gait ability in patients after stroke

2021 ◽  
Vol 57 (2) ◽  
pp. 92-102
Author(s):  
Maruša Kržišnik ◽  
Barbara Horvat Rauter ◽  
Nataša Bizovčar
Keyword(s):  
Virtual Reality ◽  
Treadmill Training ◽  
Step Test ◽  
Control Group ◽  
Walk Test ◽  
Stroke Patients ◽  
Lateral Asymmetry ◽  
Subacute Stroke ◽  
Significant Difference ◽  
Experimental Group

Gait and balance impairments contribute significantly to long-term disability after stroke. Modern concepts of stroke rehabilitation recommend a task-specific repetitive approach, such as using treadmill training. The purpose of this study was to investigate the effectiveness of using virtual reality-based treadmill training to improve balance and gait in subacute stroke patients. Twenty-two stroke patients were randomly stratified into two groups: the experimental (n = 11) and the control group (n = 11). Parameters associated with balance and gait were measured using the 6-minute walk test, the 10-meter walk test, the timed “up and go” test, the functional gait assessment, and the four square step test. Gait analysis using the zebris Rehawalk® treadmill system was also performed. Patients in the experimental group received virtual reality-based treadmill training five times a week for a period of four weeks, while those in the control group received treadmill training at the same frequency, duration, intensity, and structure, along with a progressively more difficult task demands. Significant improvements were observed in selected outcome measures in both groups after training. Patients in the experimental group experienced improvements in all of the spatiotemporal gait parameters, but there was a significant difference before and after training in duration of double support and lateral asymmetry. The findings of this pilot randomized controlled trial support the benefits of using a virtual reality-based treadmill training program to improve gait and balance in subacute stroke patients.

scholarly journals Virtual Reality Gait Training to Promote Balance and Gait Among Older People: A Randomized Clinical Trial

Geriatrics ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. 1
Author(s):  
Kyeongjin Lee
Keyword(s):  
Virtual Reality ◽  
The Elderly ◽  
Gait Training ◽  
Control Group ◽  
Timed Up And Go ◽  
Elderly Individuals ◽  
Functional Reach Test ◽  
Balance Ability ◽  
Standing Test ◽  
The One

Falls are the leading cause of injury and injury-related death in the elderly. This study evaluated the effect of virtual reality gait training (VRGT) with non-motorized treadmill on balance and gait ability of elderly individuals who had experienced a fall. Fifty-six elderly individuals living in local communities participated in this study. Subjects who met the selection criteria were randomly divided into a VRGT group (n = 28) and a control group (n = 28). The VRGT group received VRGT with non-motorized treadmill for 50 min a day for 4 weeks and 5 days a week. The control group received non-motorized treadmill gait training without virtual reality for the same amount of time as the VRGT group. Before and after the training, the one-leg-standing test, Berg Balance Scale, Functional Reach test, and Timed Up and Go test were used to assess balance ability, and the gait analyzer system was used to evaluate the improvement in gait spatiotemporal parameters. In the VRGT group, the balance ability variable showed a significant decrease in the one-leg-standing test and a significant improvement in the Timed Up and Go test. With respect to spatiotemporal gait parameters, velocity and step width decreased significantly in the VRGT group (p < 0.05), and stride length and step length were significantly improved in the VRGT group (p < 0.05). VRGT with non-motorized treadmill has been shown to improve balance and gait ability in the elderly. This study is expected to provide basic data on exercise programs for the elderly to prevent falls.

scholarly journals Fall-Prone Older People's Attitudes towards the Use of Virtual Reality Technology for Fall Prevention

Gerontology ◽  
2017 ◽  
Vol 63 (6) ◽  
pp. 590-598 ◽  
Author(s):  
Kim Dockx ◽  
Lisa Alcock ◽  
Esther Bekkers ◽  
Pieter Ginis ◽  
Miriam Reelick ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Older People ◽  
Fall Prevention ◽  
User Satisfaction ◽  
Treadmill Training ◽  
Control Group ◽  
Virtual Reality Technology ◽  
Positive Attitudes ◽  
People’S Attitudes ◽  
Attitudinal Changes

Background: Virtual reality (VR) technology is a relatively new rehabilitation tool that can deliver a combination of cognitive and motor training for fall prevention. The attitudes of older people to such training are currently unclear. Objective: This study aimed to investigate: (1) the attitudes of fall-prone older people towards fall prevention exercise with and without VR; (2) attitudinal changes after intervention with and without VR; and (3) user satisfaction following fall prevention exercise with and without VR. Methods: A total of 281 fall-prone older people were randomly assigned to an experimental group receiving treadmill training augmented by VR (TT+VR, n = 144) or a control group receiving treadmill training alone (TT, n = 137). Two questionnaires were used to measure (1) attitudes towards fall prevention exercise with and without VR (AQ); and (2) user satisfaction (USQ). AQ was evaluated at baseline and after intervention. USQ was measured after intervention only. Results: The AQ revealed that most participants had positive attitudes towards fall prevention exercise at baseline (82.2%) and after intervention (80.6%; p = 0.144). In contrast, only 53.6% were enthusiastic about fall prevention exercise with VR at baseline. These attitudes positively changed after intervention (83.1%; p < 0.001), and 99.2% indicated that they enjoyed TT+VR. Correlation analyses showed that postintervention attitudes were strongly related to user satisfaction (USQ: r = 0.503; p < 0.001). Conclusions: Older people's attitudes towards fall prevention exercise with VR were positively influenced by their experience. From the perspective of the user, VR is an attractive training mode, and thus improving service provision for older people is important.

scholarly journals Feasibility and Tolerability of a Culture-Based Virtual Reality (VR) Training Program in Patients with Mild Cognitive Impairment: A Randomized Controlled Pilot Study

2020 ◽  
Vol 17 (9) ◽  
pp. 3030 ◽  
Author(s):  
Jong-Hwan Park ◽  
Yung Liao ◽  
Du-Ri Kim ◽  
Seunghwan Song ◽  
Jun Ho Lim ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Training Program ◽  
Test Performance ◽  
Digit Span ◽  
Training Group ◽  
Control Group ◽  
Vr Training

The present study examined whether a culture-based virtual reality (VR) training program is feasible and tolerable for patients with amnestic mild cognitive impairment (aMCI), and whether it could improve cognitive function in these patients. Twenty-one outpatients with aMCI were randomized to either the VR-based training group or the control group in a 1:1 ratio. The VR-based training group participated in training for 30 min/day, two days/week, for three months (24 times). The VR-based program was designed based on Korean traditional culture and used attention, processing speed, executive function and memory conditions to stimulate cognitive function. The adherence to the culture-based VR training program was 91.55% ± 6.41% in the VR group. The only adverse events observed in the VR group were dizziness (4.2%) and fatigue (8.3%). Analysis revealed that the VR-based training group exhibited no significant differences following the three-month VR program in Korean Mini-Mental State Examination (K-MMSE) scores, working memory functions such as performance on the digit span test, or in Stroop test performance and word fluency. We conclude that although the 12-week culture-based VR training program did not improve cognitive function, our findings revealed that the culture-based VR training program was feasible and tolerable for participants with aMCI.

scholarly journals Evaluation of the Effectiveness of a Training Program on Violence against Children and Adolescents

2020 ◽  
Vol 44 (4) ◽  
Author(s):  
Murilo Sabbag Moretti ◽  
Alex Sandro Gomes Pessoa
Keyword(s):  
Medical Students ◽  
Training Program ◽  
Health Professionals ◽  
Intervention Program ◽  
Control Group ◽  
Undergraduate Medical Students ◽  
Postgraduate Students ◽  
Violence Against Children ◽  
Positive Effects ◽  
Post Test

Abstract: Introduction: Assistance in health services is often the first possibility for the identification of cases of Violence Against Children and Teenagers (VACT). Therefore, the aim of this article was to evaluate the effectiveness of an intervention program developed to enable students and health professionals to recognize and report cases of VACT. Additionally, we sought to verify at what level of training (undergraduate, postgraduate or working professional) such intervention would show the greatest effect. Method: This is a quasi-experimental study, of which design was based on the analysis of a non-equivalent Control Group (CG). The research included undergraduate medical students, postgraduate medical students attending pediatric residency and professionals working in health institutions. A total of 105 people participated, of which 89% were women. The participants were subsequently subdivided between the Experimental Group - EG (n = 60) and Control Group - CG (n = 45). A training program on the topic, consisting of 10 sessions (20h in total), was developed and applied with an EG. To assess the effectiveness of the intervention, a questionnaire was applied at previously determined periods (pre-test and post-test). The data were submitted to statistical analysis (descriptive analyses, t test and Tukey’s multiple comparison test), using the software R. Results: The post-test showed statistically significant changes in all dimensions evaluated with the EG, which proves that the intervention resulted in changes regarding the previous conceptions that the participants had about VACT. Additionally, when comparing the responses obtained in the questionnaires between the three EG groups (undergraduate, postgraduate students and working professionals), it was verified that there were no statistical differences between the groups, suggesting that educational programs have positive effects on all levels of training. Conclusions: This study showed that training programs can qualify the conception of students and health professionals, as well as help them feel more prepared to deal with the demands related to VACT. However, a collective effort is needed so that these contents are purposefully incorporated into the training process at all levels, from undergraduate school to continuing education.

scholarly journals Effects of Individualized Functional Training on the Physical Fitness of Women with Obesity

2020 ◽  
Vol 25 (268) ◽  
pp. 61-75
Author(s):  
Greice Westphal ◽  
Silvia Beatriz Serra Baruki ◽  
Tamires Alessa de Mori ◽  
Maria Imaculada de Lima Montebello ◽  
Eli Maria Pazzianotto-Forti
Keyword(s):  
Physical Fitness ◽  
Training Program ◽  
Cardiorespiratory Fitness ◽  
Functional Capacity ◽  
Public Health Problem ◽  
Lower Limbs ◽  
Step Test ◽  
Controlled Study ◽  
Control Group ◽  
Functional Training

Introduction: Obesity is a global public health problem with negative impact on health. Therefore, effective treatments options are needed. Objective: to evaluate the responses of a supervised functional training program on physical fitness and functional capacity of women with obesity. Methods: a prospective and controlled study was conducted with twenty-four women, BMI >30 and <55 kg/m² and age between 20 and 59 years. The evaluation consisted of anthropometric measurements and physical fitness tests that assessed the cardiorespiratory fitness and functional capacity [6-minute step test (ST6min)], the indirect strength of the lower limbs [sit-to-stand test (STS)] and the flexibility [sit and reach test (SR)]. After the baseline evaluations, the volunteers were allocated in two groups: individualized training group (ITG) (n=13), which consisted of aerobic and strength training, for three months, three times a week, 60 minutes per session; and the control group (CG) (n=11) which did not participate in any regular physical exercise program during the same period. At the third month the two groups were reassessed. Results: it was observed significative reductions in waist circumference, hip and neck measurements; all with p<0.01; and increase in VO2max, in the number of movements of STS and in distance reached in the SR test, all with p<0.01 for the ITG. The ITG showed superiority over CG for all exercise test variables studied. Conclusion: The training program improved the distribution of body fat, cardiorespiratory fitness, muscular strength, flexibility and functional capacity. These are indicatives that the strategy is feasible for women with obesity.

scholarly journals The Effect of Virtual Reality-Based Therapy on Improving Upper Limb Functions in Individuals With Stroke: A Randomized Control Trial

2021 ◽  
Vol 13 ◽  
Author(s):  
Ehab Mohamed Abd El-Kafy ◽  
Mansour Abdullah Alshehri ◽  
Amir Abdel-Raouf El-Fiky ◽  
Mohamad Abdelhamid Guermazi
Keyword(s):  
Virtual Reality ◽  
Training Program ◽  
Upper Limb ◽  
Chronic Stroke ◽  
Control Group ◽  
Stroke Incidence ◽  
Functional Training ◽  
Significant Difference ◽  
And Control ◽  
Experimental Group

Background: Stroke is a common cause of motor disability. The recovery of upper limb after stroke is poor, with few stroke survivors regaining some functional use of the affected upper limb. This is further complicated by the fact that the prolonged rehabilitation is accompanied by multiple challenges in using and identifying meaningful and motivated treatment tasks that may be adapted and graded to facilitate the rehabilitation program. Virtual reality-based therapy is one of the most innovative approaches in rehabilitation technology and virtual reality systems can provide enhanced feedback to promote motor learning in individuals with neurological or musculoskeletal diseases.Purpose: This study investigated the effect of virtual reality-based therapy on improving upper limb functions in individuals with chronic stroke.Methods: Forty Saudi individuals with chronic stroke (6–24 months following stroke incidence) and degree of spasticity ranged between 1, 1 + and 2 according to Modified Ashworth Scale were included in this study. Participants were randomly assigned into two groups, experimental and control, with the experimental group undertaking a conventional 1-h functional training program, followed by another hour of virtual reality-based therapy using Armeo Spring equipment and the control group received 2 h of a conventional functional training program. The treatment program was conducted three times per week for three successive months. The change in the scores of Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), WMFT-Time (time required to complete the test) and Hand Grip Strength (HGS) were recorded at baseline and after completion of the treatment. Parametric (paired and unpaired t-tests) non-parametric (Wilcoxon and Mann–Whitney tests) statistical tests were used to identify the differences within and between groups (experimental group and control group) and evaluation times (pre- and immediately post-treatment).Results: Both groups showed significant differences (all, P &lt; 0.05) in all measured variables after 3 months of the treatment. Individuals with stoke in the experimental group had a better improvement in ARAT (P &lt; 0.01), WMFT (P &lt; 0.01) and WMFT-Time (P &lt; 0.01) scores after completion of the treatment compared to the control group. No significant difference in HGS scores was detected between groups after completion of the treatment (P = 0.252).Conclusion: The use of combined treatment of virtual reality-based therapy and conventional functional training program is more effective for improving upper limb functions in individuals with chronic stroke than the use of the conventional program alone.

scholarly journals Pain perception of overweight forestry workers: A retrospective study on effects of an occupational training program

2017 ◽  
Vol 66 (1) ◽  
pp. 14-20
Author(s):  
Sabrina Rudolph ◽  
Arne Göring ◽  
Malte Jetzke
Keyword(s):  
Training Program ◽  
Musculoskeletal Pain ◽  
Pain Perception ◽  
Training Intervention ◽  
Control Group ◽  
Specific Training ◽  
Occupational Training ◽  
Positive Effects ◽  
Body Regions ◽  
Forestry Workers

Abstract Objective: Forestry work is associated with intensive musculoskeletal stress. Physical exercise reduces musculoskeletal pain, especially for people with overweight. The aim of this study is to investigate the effects of a training intervention on the pain perception of overweight forestry workers. Methods: The intervention group (IG), split in an overweight (BMI (body mass index) ≥ 26 kg/m2) and a normal weight (BMI < 26 kg/m2) sample, did an occupational training intervention. The control group (CG) did no specific training program. The Nordic Questionnaire was used for ascertaining the perception of musculoskeletal pain. Results: The IG with overweight referenced a lower pain perception compared to the CG in all seven body regions. The differences in shoulder (p = 0.01, τ= 0.22) and lower back (p = 0.04, τ = 0.18) were significant. No differences could be found in the two groups with a BMI < 26 kg/m2. Conclusion: The results indicate that a specific training intervention has positive effects on the perception of pain for the workers with overweight.

scholarly journals Effect of Platform Swing Walkway on Locomotor Behavior in Children With Diplegic Cerebral Palsy: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Hanaa Mohsen ◽  
Omnya Samy
Keyword(s):  
Cerebral Palsy ◽  
Physical Therapy ◽  
Motor Function ◽  
Gait Training ◽  
Therapeutic Modality ◽  
Control Group ◽  
Study Group ◽  
Sensory Stimuli ◽  
Gait Parameters ◽  
Before And After

BACKGROUND Limited attention has been given to the effectiveness of the platform swing walkway, which is a common way to improve gait pattern through activation of sensory stimuli (visual, auditory, vestibular, and somatosensory). OBJECTIVE The objective of this study was to determine the effect of a platform swing walkway on gait parameters in children with diplegic cerebral palsy (CP). METHODS A total of 30 children of both sexes (aged 6-8 years) with diplegic CP were enrolled in this study. They were randomly assigned into two groups of equal number: the control group (n=15) and the study group (n=15). The control group received the conventional physical therapy plan, whereas the study group received the same conventional physical therapy program in addition to gait training on a platform swing walkway. Temporal parameters during the gait cycle were collected using gait tracker video analysis, and the Growth Motor Function Measure Scale (GMFM-88) was used to assess standing and walking (Dimensions D and E) before and after the treatment program. RESULTS A statistically significant improvement in both groups was noted when comparing the mean values of all measured variables before and after treatment (<i>P</i>≤.05). There were significant differences between the control and study groups with respect to all measured variables, which favored the study group when comparing the posttreatment outcomes (<i>P</i>≤.05). CONCLUSIONS Results suggest that gait training on platform swing walkways can be included as an alternative therapeutic modality to enhance gait parameters and gross motor function in children with diplegic CP. CLINICALTRIAL ClinicalTrials.gov NTC04246658; https://clinicaltrials.gov/ct2/show/NTC04246658

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