Does virtual reality training using the Xbox Kinect have a positive effect on physical functioning in children with spastic cerebral palsy? A case series.

PURPOSE: The present study investigated the effects of virtual reality (VR) training using the Xbox Kinect on motor function, balance, gait, and functional mobility in children with cerebral palsy (CP). METHOD: This was a case series. Four children with spastic diplegic cerebral palsy were provided VR training using the Xbox Kinect for 12 sessions (three sessions per week for 4 weeks). At baseline and follow-up, physical function was measured using the following: Selective Motor Control (SMC) for motor function, Pediatric Balance Scale (PBS) for balance, Timed Up and Go (TUG) test and Functional Mobility Scale (FMS) for functional mobility, and 6-meter walk test (6WT) for gait. RESULTS: As compared with the baseline scores, SMC, PBS, TUG, FMS, and 6MWT scores after training showed improvements. In participant 1, PBS and TUG scores improved after VR training. In participant 2, SMC (left ankle dorsiflexor, left knee extensor), PBS, TUG, and FMS scores improved after training. In participant 3, SMC (left hip flexor), TUG, FMS, and 6MWT scores improved after training. In participant 4, SMC (right ankle dorsiflexor), PBS, TUG, FMS, and 6MWT scores improved after training. CONCLUSION: The results show that VR training using the Xbox Kinect may improve physical functioning in children with spastic diplegic cerebral palsy. However, its utility in the rehabilitation of children with CP requires further investigation.

Validity of the Original and Short Versions of the Dynamic Gait Index in Predicting Falls in Stroke Survivors.

PURPOSE: This study aimed to investigate the validity of the original version and short version of the Dynamic Gait Index (DGI-8 and DGI-4) in predicting falls in stroke survivors. DESIGN: This is a retrospective, cross-sectional study. METHOD: This study collected data for 57 chronic stroke survivors and evaluated the validity of the DGI-8 and DGI-4. To test functional ability, the Sit-to-Stand Test, gait subscale of the Performance-Oriented Mobility Assessment, the 10-m Walk Test, the Fugl-Meyer assessment, and the Trunk Impairment Scale were used. FINDINGS: For the DGI-8, the cutoff value for the prediction of a fall was shown to be 16.5, with an area under the curve (AUC) of 0.78. The cutoff value of the DGI-4 was shown to be 9.5, with an AUC of 0.77. CONCLUSIONS: The study results show that the DGI-8 and DGI-4 have discrimination in the prediction of fall in stroke survivors. CLINICAL RELEVANCE: DGI-8 and DGI-4 can be useful for predicting falls of stroke patients, allowing better quality of care.

Treadmill training with tilt sensor functional electrical stimulation for improving balance, gait, and muscle architecture of tibialis anterior of survivors with chronic stroke: A randomized controlled trial.

BACKGROUND: Gait training is important for stroke rehabilitation, such as using the treadmill training with functional electrical stimulation (FES). OBJECTIVE: This study was to investigate the effects of the treadmill training with tilt sensor FES on the balance, gait, and muscle architecture of the tibialis anterior in stroke survivors. METHODS: The study was a randomized controlled trial. Thirty-four stroke survivors were recruited and screened eligibility criteria. Thirty-two participants were randomly allocated to two groups using random allocation software: Treadmill training with Tilt Sensor FES (TTSF) group (n= 16) and Treadmill training with Placebo Tilt Sensor FES (TPTSF) group (n= 16). TTSF group performed gait training on treadmill with tilt sensor FES, and TPTSF group performed gait training on treadmill with placebo tilt sensor FES. Two participants were dropped during this study, and 30 participants were included at post-test. Balance and gait were measured using the timed up and go (TUG) test, berg balance scale (BBS), and 10 m walk test (10 mWT). Ultrasound imaging was used to measure the muscle architecture of the tibialis anterior. RESULTS: After intervention, there were significant improvements in the TUG, BBS, and 10 mWT compared to baseline in both groups (p< 0.05). At follow-up, the TUG, BBS, 10 mWT, and muscle architecture of tibialis anterior on the paretic side showed significant improvements in the TTSF group compared to TPTSF group (p< 0.05). CONCLUSIONS: The findings of this study suggest that TTSF can be an effective intervention for improving balance, gait ability, and muscle architecture of tibialis anterior of stroke survivors.

Effects of motor imagery training on balance and gait abilities in post-stroke patients: a randomized controlled trial.

OBJECTIVES: To investigate the effects of motor imagery training on the balance and gait abilities of post-stroke patients. DESIGN: Randomized controlled trial. SETTING: Outpatient rehabilitation centre. SUBJECTS: Twenty-eight individuals with chronic stroke. INTERVENTIONS: The experimental group (n = 15) performed motor imagery training involving imagining normal gait movement for 15 minutes embedded in gait training for 30 minutes (45 minutes/day, 3 times/week); the control group (n = 13) performed gait training only (30 minutes/day, 3 times/week). MAIN MEASURES: Balance and gait abilities were measured by the Functional Reach Test, Timed Up-and-Go Test, 10-m Walk Test and Fugl-Meyer assessment before and after interventions. RESULTS: All measurements improved significantly compared with baseline values in the experimental group. In the control group, there were significant improvements in all parameters except the Fugl-Meyer assessment. All parameters of the experimental group increased significantly compared to those of the control group as follows: Functional Reach Test (control vs. experimental: 28.1 ± 3.1 vs. 37.51 ± 3.0), Timed Up-and-Go Test (20.7 ± 4.0 vs. 13.2 ± 2.2), 10-m Walk Test (17.4 ± 4.6 vs. 16.0 ± 2.7) and Fugl-Meyer assessment (12.0 ± 2.9 vs. 17.6 ± 1.3). CONCLUSIONS: Gait training with motor imagery training improves the balance and gait abilities of chronic stroke patients significantly better than gait training alone.