Effect of Virtual Reality Gait Training on Participation in Survivors of Subacute Stroke: A Randomized Controlled Trial.
Ilona J M de Rooij, Ingrid G L van de Port, Michiel Punt and 5 others
PMID 33594443WHAT IT FOUND
Virtual reality gait training did not improve community participation more than standard treadmill training in stroke survivors.
Both groups improved, and patients found the virtual reality approach safe and enjoyable, but it offered no statistical advantage over conventional care.
Key findings
01There was no statistically significant difference in the improvement of participation restrictions between the virtual reality group and the standard care group over time.
02Both interventions led to significant improvements in participation and dynamic balance when analyzed together, regardless of group allocation.
03Participants experienced the virtual reality training as safe and enjoyable, citing opportunities for dual-tasking and reactive balance as key advantages, though they also noted technical deficits and awareness of the safety harness.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample size may have been too small to detect a true difference due to large variability in baseline participation restrictions. The same therapists delivered both interventions, which could have led to contamination of techniques or unconscious bias in treatment delivery. Participants in the VR group had a longer time since stroke on average, which might have affected their potential for spontaneous recovery, though sensitivity analyses adjusted for this. The study did not measure underlying walking impairments or specific patient goals, limiting the ability to personalize the VR training optimally.
Declared interests
The study was funded by Stichting Revant Innovatie. The funder played no role in the design, conduct, or reporting of the study.
The easy way to misread this
Do not conclude that VR training is ineffective because it did not beat standard care. Both groups improved significantly in participation and balance, meaning VR is a valid, safe, and patient-preferred option, even if it is not statistically superior to conventional treadmill training.