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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

Figures

Figure 1.
Figure 1.

Flow diagram of total experimental procedure.
Figure 2.
Figure 2.

(A) Simplified mechanical structure of the dynamic balance board. (B) Virtual reality balance training system with the dynamic balance board. (C) Simulated outdoor environment (D) Simulated indoor environment.
Appendix 1.
Appendix 1.

Virtual Reality–Augmented Balance Training Protocols
Appendix 2.
Appendix 2.

Conventional Balance Training Protocols

Tables

Table 1.
Table 1.

Demographic Characteristics and Baseline Data of Participants (N=42)a

  • ↵a Values are mean (SD). VR=virtual reality training; CB=conventional balance training; H-Y=Hoehn and Yahr; UPDRS-III=Unified Parkinson's Disease Rating Scale, part III; MMSE=Mini-Mental State Examination.
Table 2.
Table 2.

Equilibrium Scores for the Sensory Organization Test (SOT) Among Groups Before and After Training and at Follow-up During Single and Dual Tasksa

  • ↵a Values are means (95% confidence interval). VR=virtual reality training, CB=conventional balance training.

  • b Group × time interaction for SOT-5: F2.7,78=4.15, P=.009.

  • c Group × time interaction for SOT-6: F2.6,78=3.65, P=.023.

  • d Significantly different from before training, alpha level=.05/3.

  • e Significantly different from control group, alpha level=.05/3.
Table 3.
Table 3.

Sensory Ratio of Sensory Organization Test (SOT) Among Groups Before and After Testing and at Follow-up During Single and Dual Tasksa

  • ↵a Values are means (95% confidence interval). VR=virtual reality training, CB=conventional balance training, SOM=somatosensory, VIS=vision, VES=vestibular, PREF=preference.

  • b Group × time interaction for VES: F2.7,78=4.32, P=.01.

  • c Significantly different from before training, alpha level=.05/3.

  • d Significantly different from control group, alpha level=.05/3.
Table 4.
Table 4.

Verbal Reaction Time (VRT) for Arithmetic Subtraction Under Single Secondary Task and Dual Task Sensory Organization Test (SOT) Conditions Among Groups Before and After Training and at Follow-upa

  • ↵a Values are means (95% confidence interval). VR=virtual reality training, CB=conventional balance training.

  • b The 2-way mixed analysis of variance did not show any significant group × time interaction or main effect of group and time in any of the 6 SOT conditions while standing.

  • c The VRT at SOT-1 with eyes open, on firm supported surface, and with static standing was the baseline response, which can be viewed as the single secondary task (ie, arithmetic subtraction task) while standing.

  • d P<.05, if single secondary task while sitting versus SOT-1 while standing in each group.

  • e VR group (n=11), CB group (n=10), control group (n=9); no intention-to-treat analysis performed.

  • f VR group (n=11), CB group (n=9), control group (n=9); no intention-to-treat analysis performed.

Supplementary Data

Demonstration Video of Virtual Reality Balance Training With a Person With Parkinson Disease

To view this video, use the latest versions of QuickTime or Windows Media Player.

• To get the latest version of QuickTime, click here.
• To get the latest version of Windows Media Player, click here.

Files in this Data Supplement:

  • Demonstration Video - A person with Parkinson disease receives the virtual reality balance training by standing on an interactive platform. While under the supervision of a physical therapist, the indoor and outdoor activities are performed with arms fixed or unfixed. Running time: 1:07 (12.9 MB).
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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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