Home-Based Nonimmersive Virtual Reality Training After Discharge From Inpatient or Outpatient Stroke Rehabilitation: Parallel Feasibility Randomized Controlled Trial.
Lisa Sheehy, Anne Taillon-Hobson, Heidi Sveistrup and 4 others
PMID 40153779WHAT IT FOUND
Home virtual reality balance and gait training after stroke was feasible and safe, but did not improve balance, gait or function more than iPad apps.
Both groups improved some measures over six weeks.
Key findings
01All 20 participants completed the study, and there were no serious adverse events, with 3 minor adverse events reported.
02The virtual reality group did not improve balance, gait, function or community integration more than the iPad group, because no significant group differences were found.
03When both groups were combined, several physical and participation measures improved over the 6-week period, but the improvement was not greater in the virtual reality group.
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
This was a feasibility trial with 20 participants and no sample size calculation, so it cannot show whether virtual reality training works better than iPad apps. Recruitment was 3 of 403 inpatients and 17 of 290 outpatients, so many eligible patients may not have been reached. The sample was mostly male: the NIVRT group had 10 male and 1 female participants, and the iPad group had 6 male and 3 female participants. All participants had Wi-Fi and most had computer experience, which may limit transfer to people with lower socioeconomic status or less technology access. Other rehabilitation or exercise during the study was not tracked, so outcome changes may have come from activities outside the trial. Participants knew their group, and only the assessment physiotherapist was blinded. Home setup needed space and technical ability; 5 participants had less than 2.0 m of unobstructed space, which made camera tracking difficult. Some participants could not complete certain tests due to weakness, gait aids, language barriers or cognitive issues.
Declared interests
One author, LS, received a travel subsidy from the StrokeCog Clinical Trials Training Platform to attend the World Stroke Congress, Toronto, 2023. No other conflicts or study funding are reported.
The easy way to misread this
Do not read the improvements in both groups as evidence that virtual reality training caused better recovery. The trial was a small feasibility study, not powered for efficacy, found no significant differences between groups, and participants may have done other untracked exercises.