Article

OBJECTIVE: To evaluate gait biomechanics after training with a virtual reality
(VR) system and to elucidate underlying mechanisms that contributed to the
observed functional improvement in gait speed and distance. DESIGN: A single
blind randomized control study. SETTING: Gait analysis laboratory in a
rehabilitation hospital and the community. PARTICIPANTS: Fifteen men and three
women with hemiparesis caused by stroke. INTERVENTIONS: Subjects trained on a
six-degree of freedom force-feedback robot interfaced with a VR simulation.
Subjects were randomized to either a VR group (n=9) or non-VR group (NVR, n=9).
Training was performed three times a week for 4 weeks for approximately 1h each
visit. MAIN OUTCOME MEASURES: Kinematic and kinetic gait parameters. RESULTS:
Subjects in the VR group demonstrated a significantly larger increase in ankle
power generation at push-off as a result of training (p=0.036). The VR group had
greater change in ankle ROM post-training (19.5%) as compared to the NVR group
(3.3%). Significant differences were found in knee ROM on the affected side
during stance and swing, with greater change in the VR group. No significant
changes were observed in kinematics or kinetics of the hip post-training.
CONCLUSIONS: These findings are encouraging because they support the potential
for recovery of force and power of the lower extremity for individuals with
chronic hemiparesis. It is likely that the effects of training included improved
motor control at the ankle, which enabled the cascade of changes that produced
the functional improvements seen after training.
CI - Copyright 2010 Elsevier B.V. All rights reserved.

Langue : ANGLAIS