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Effects of Virtual Reality–Augmented Balance Training on Sensory Organization and Attentional Demand for Postural Control in People With Parkinson Disease: A Randomized Controlled Trial

Chang-Yi Yen, Kwan-Hwa Lin, Ming-Hsia Hu, Ruey-Meei Wu, Tung-Wu Lu, Chia-Hwa Lin
DOI: 10.2522/ptj.20100050 Published 1 June 2011
Chang-Yi Yen
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Kwan-Hwa Lin
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Ming-Hsia Hu
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Ruey-Meei Wu
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Tung-Wu Lu
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Chia-Hwa Lin
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Abstract

Background There is a lack of studies related to virtual reality (VR)–augmented balance training on postural control in people with Parkinson disease (PD).

Objective The purposes of this study were: (1) to examine the effects of VR-augmented balance training on the sensory integration of postural control under varying attentional demands and (2) to compare the results with those of a conventional balance training (CB) group and an untrained control group.

Design A longitudinal, randomized controlled trial was used.

Setting The intervention was conducted in the clinic, and the assessment was performed in a research laboratory.

Patients Forty-two people with PD (Hoehn and Yahr stages II–III) were recruited.

Intervention The VR and CB groups received a 6-week balance training program.

Measurements The sensory organization tests (SOTs) of computerized posturography with single- and dual-task conditions were conducted prior to training, after training, and at follow-up. Equilibrium scores, sensory ratios, and verbal reaction times (VRTs) were recorded.

Results There were no significant differences in equilibrium scores or VRTs between the VR and CB groups. However, the equilibrium scores in SOT-6 (ie, unreliable vision and somatosensation) of the VR group increased significantly more than that of the control group after training. The equilibrium scores in SOT-5 (ie, unreliable somatosensation with eyes closed) of the CB group also increased significantly more than that of the control group after training.

Limitations The functional significance of the improvements in equilibrium scores in the SOTs was not known, and the sample size was small.

Conclusions Both VR and CB training improved sensory integration for postural control in people with PD, especially when they were deprived of sensory redundancy. However, the attentional demand for postural control was not changed after either VR or CB training.

Footnotes

  • All authors provided concept/idea/research design. Mr Yen, Dr K.-H. Lin, Dr Hu, and Dr Lu provided writing and data analysis. Mr Yen, Dr K.-H. Lin, and Dr Lu provided data collection. Dr. K.-H. Lin provided project management and fund procurement. Dr Wu provided participants. Dr K.-H. Lin and Dr Hu provided facilities/equipment. Dr Hu, Dr Wu, Dr Lu, and Dr C.-H. Lin provided consultation (including review of manuscript before submission).

  • The authors thank Mr Jason Chen in the Cycling & Health Tech Industry R & D Center, Taichung, Taiwan, for developing the dynamic tilting balance board for VR training. The authors also thank Assistant Professor Jason Chien-Shun Lo and Mr Chen-Shin Yu, Department of Multimedia Design, National Formosa University, Yunlin, Taiwan, for their effort in constructing the simulated (virtual) indoor and outdoor activities for training.

  • The study was partly supported by the National Science Council, Taipei, Taiwan (NSC 97-2314-B-002-009-MY3).

  • Trial registration: ClinicalTrials.gov Identifier: NCT01301651.

  • Received February 3, 2010.
  • Accepted January 31, 2011.
  • © 2011 American Physical Therapy Association
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Vol 96 Issue 12 Table of Contents
Physical Therapy: 96 (12)

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Effects of Virtual Reality–Augmented Balance Training on Sensory Organization and Attentional Demand for Postural Control in People With Parkinson Disease: A Randomized Controlled Trial
Chang-Yi Yen, Kwan-Hwa Lin, Ming-Hsia Hu, Ruey-Meei Wu, Tung-Wu Lu, Chia-Hwa Lin
Physical Therapy Jun 2011, 91 (6) 862-874; DOI: 10.2522/ptj.20100050

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Effects of Virtual Reality–Augmented Balance Training on Sensory Organization and Attentional Demand for Postural Control in People With Parkinson Disease: A Randomized Controlled Trial
Chang-Yi Yen, Kwan-Hwa Lin, Ming-Hsia Hu, Ruey-Meei Wu, Tung-Wu Lu, Chia-Hwa Lin
Physical Therapy Jun 2011, 91 (6) 862-874; DOI: 10.2522/ptj.20100050
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  • Reliability and Validity of Force Platform Measures of Balance Impairment in Individuals With Parkinson Disease
  • Predictors of Reduced Frequency of Physical Activity 3 Months After Injury: Findings From the Prospective Outcomes of Injury Study
  • Effects of Locomotor Exercise Intensity on Gait Performance in Individuals With Incomplete Spinal Cord Injury
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