Game-Based Virtual Reality Training Improves Sitting Balance after Spinal Cord Injury: A Single-Blinded, Randomized Controlled Trial

BACKGROUND: Virtual reality (VR) is a useful device for rehabilitation methods. It is a motivational device to stimulate physical activity and function. The aim of this study was to investigate the effect of game-based VR training using Nintendo Wii on sitting balance ability in participants with spinal cord injury (SCI).
MATERIAL AND METHODS: SCI survivors (N=26, American Spinal Injury Association Impairment Scale category A or B) were randomly allocated into the following 2 groups: the virtual reality group (n=13) and the control group (n=13). Both groups received conventional rehabilitation for 5 sessions 60~90 minutes per week for 6 weeks. The VR group completed an additional 6 weeks (30 minutes ×3 sessions/week) of Nintendo Wii-based VR balance training to improve static balance ability (postural sway distance, postural sway velocity) and dynamic balance ability (modified functional reach test [mFRT], T-shirt test).
RESULTS: Both groups showed significant improvement in static and dynamic balance ability (p<.05). When comparing among groups, there was significant improvement in static and dynamic balance ability with respect to; anterior-posterior (AP) and total postural sway distance (p<.05); AP and total postural sway velocity (p<.05); left, front and right mFRT (p<.05); and the T-shirt test (p<.05). There was no significant change in mediolateral (ML) postural sway distance and velocity.
CONCLUSIONS: VR training improved static and dynamic balance ability in SCI survivors, and its application may be useful as a balance improvement program in home and inpatient rehabilitation for SCI.

Keywords: postural balance, Rehabilitation, Spinal Cord Injuries, Virtual Reality Exposure Therapy