Effectiveness of Virtual Rehabilitation Versus Therapeutic Exercises in the Balance Training of Lower Limb Among Post-Stroke Patients

Abstract

Background: Stroke is the major source of death and disability and leads to impaired balance in post-stroke patients. Balance training is one of the main components of stroke rehabilitation. Virtual rehabilitation is gaining more popularity as it engages the patients attention in training. Objective: To evaluate the effects of virtual rehabilitation versus therapeutic exercises to improve the balance in patients with stroke. Methods: This randomized controlled trial conducted at Abdullah Hospital, Lalamusa from August  to December 2022. The sample size of 30 participants was randomly divided into two groups virtual therapy group versus therapeutic exercises group, after taking their informed consent. Participants were recruited through the non-probability purposive sampling, between the age of 35 to 55 years, post-stroke survivors after 3 months and were able to stand up with or without assistive devices. Participants with auditory or visual dysfunction, a history of deep venous thrombosis, lower limb amputation, severe receptive or expressive aphasia, significant cognitive impairments and unstable hypertension were excluded. The data was collected from the patients by using Berg Balance Scale (BSS) at three different time frames: baseline, mid-intervention and post-intervention. The Shapiro-Wilk test was applied to calculate the normality of the data.  For descriptive analysis, quantitative variables were calculated by mean and standard deviation whereas, for qualitative variables, frequency and percentages were used. To find significance an independent sample t-test was applied for between-group analysis and two-way repeated measure ANOVA was used to measure within-group analysis. Results: Both groups improved their balance after six months of intervention. Comparative analysis showed a significant improvement with p-value≤0.05 in both groups. The mean and standard deviation after six weeks of intervention in the virtual training group was 55.4±0.82 and the therapeutic exercise group was 54.47±1.3. This showed that the virtual rehabilitation group had improved balance in patients with stroke. Conclusion: Virtual rehabilitation was found to be effective in improving the balance of patients with stroke. It not only improves balance but also engages the patient in the treatment protocol. This rehabilitation is effective for the balance training of post-stroke patients.