Effects of the home-based exercise program with an augmented reality system on balance in patients with stroke: a randomized controlled trial

Abstract

Purpose

To investigate the therapeutic potentials of the home-based exercise program (HEP) with an augmented reality (AR) system to improve balance in patients with stroke.

Methods

Sixty-eight patients with stroke were recruited in this randomized controlled study with blind observer. Patients in the smart-rehab group underwent HEP with an AR system for four weeks, whereas patients in the control group underwent the written and pictorial HEP. Assessments of balance and fear of falling were performed three times: at baseline (T0), immediately (T1), and four weeks (T2) after cessation of HEP.

Results

The change in balance from T0 to T1 was significantly higher in the smart-rehab group than in the control group (p < 0.017). The change in fear of falling from T0 to T1 and T2 was significantly higher in the smart-rehab group than in the control group, respectively (p < 0.017). One participant with vertebral artery dissection in the smart-rehab group discontinued participation due to a transient ischemic attack which resolved during the study period.

Conclusions

The results of this study suggest that the HEP with the AR system might be effective to improve balance in patients with stroke. However, more careful precautions for the HEP using the AR system are also required.

Implications for rehabilitation

• Balance was modestly improved in both home-based exercise programs, slightly more in AR home exercise group.

• AR home-based program was significantly better in reducing fear of falling compared to the control group.

• No falls were recorded, however, safety for patients with arterial dissection needs to be carefully considered due to the possibility of adverse effects.

Keywords:

• Rehabilitation
• home care services
• augmented reality
• stroke
• balance

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

Dr. JIL – design and conceptualization of the study, analysis and interpretation of the data, and drafting the manuscript. Dr. JP – data acquisition and analysis, analysis and interpretation of the data, and drafting the manuscript. Dr. JK - data acquisition and analysis. Ms. MS – data acquisition. Dr. JIH – critical revision of the manuscript for important intellectual content. Dr. JYL – critical revision of the manuscript for important intellectual content. Dr. WHC – design and conceptualization of the study, analysis and interpretation of the data, and drafting the manuscript

Additional information

Funding

This study was supported by the National Information Society Agency funded by the Ministry of Science and ICT [Grant number: 2017-0-00902] and a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health Welfare, Republic of Korea [grant number: HR21C0885].