Functional changes in the lower extremity after non-immersive virtual reality and physiotherapy following stroke.

OBJECTIVE To analyse the effect of virtual reality therapy combined with conventional physiotherapy on balance, gait and motor functional disturbances, and to determine whether subacute ( 6 months) phases might influence motor recovery. METHODS A total of 59 stroke inpatients (age 60.3±14.8 years; 14.0±25.7 months post-stroke) were stratified into 2 groups: subacute (n  =  31) and chronic (n  =  28). Clinical scales (Fugl-Meyer lower extremity (FM LE); Functional Independence Measure (FIM); Berg Balance Scale (BBS); Functional Ambulation Category (FAC); modified Ashworth scale (MAS); 10-metre walk test (10MWT); and kinematic parameters during specific motor tasks in sitting and standing position (speed; time; jerk; spatial error; length) were applied before and after treatment. The virtual reality treatment lasted for 15 sessions, 5 days/week, 1 h/day. RESULTS The subacute group underwent significant change in all variables, except MAS and length. The chronic group underwent significant improvement in clinical scales, except MAS and kinematics. Motor impairment improved in the severe, moderate and mild groups. Neither time since stroke onset nor affected hemisphere differed significantly between groups. Significant correlations were observed only between spatial error, jerk and BBS. Moreover, FM LE, BBS, MAS, and speed showed high correlations (R2> 0.70) with independent variables. CONCLUSION Virtual reality therapy combined with conventional physiotherapy can contribute to functional improvement in the subacute and chronic phases after stroke.