A Decade of Progress Using Virtual Reality for Poststroke Lower Extremity Rehabilitation: Systematic Review of the Intervention Methods

Table 1

Synthesis of results.

Author; year; PEDro	Group/sample	Age range years	Time since stroke onset	Type of VR	Type of feedback	Sessions	Outcome; measures
Jaffe et al.; (2004) [12]; PEDro: 4/10	ROT: 10; OVR: 10	60 mean	Chronic; 3-4 years	Immersive: VR scripting language	Visual, vibrotactile, auditory	6 ses.; 1 h/d, 3 d/w, 2 w	Stride gait analysis system, obstacle test, 6MWT
You et al.; (2005) [13]; PEDro: 5/10	VR: 5; C: 5	54 mean	Chronic; 1-2 years	Semi-immersive: IREX VR system	KR/KP	20 ses. 1 h/d, 5 d/w, 4 w	FAC, MMAS, fMRI
Mirelman et al.; (2009) [14]; PEDro: 5/10	R + VR: 9; R: 9	61 mean	Chronic; 3-4 years	Semi-immersive: Rutgers Ankle	KR/KP	12 ses.; 1 h/d, 3 d/w, 4 w	Gait speed, 6MWT, PAM (gait spatiotemporal parameters)
Yang et al.; (2008) [3]; PEDro: 6/10	TT: 9; VRTT: 11	58 mean	Chronic; 6 years	Immersive: visual screen, 3D; Fastrak Polhemus	Auditory, visual	9 ses.; 20 m/d, 3 d/w, 3 w	Walking speed, WAQ,; ABC scale
Kim et al.; (2009) [15]; PEDro: 6/10	CP + VR: 12; CP: 12	51 mean	Chronic; 2-3 years	Semi-immersive: IREX VR system	KR/KP	16 ses.; CP: 40 m/d, 4 d/w, 4 w; VR: 30 m	BPM, BBS, 10MWT, MMAS, GAITRite
Mirelman et al.; (2010) [16]; PEDro: 3/10	R + VR: 9; R: 9	61 mean	Chronic; 3-4 years	Semi-immersive: Rutgers Ankle	KR/KP	12 ses.; 1 h/d, 3 d/w, 4 w	Gait analysis (kinematic and kinetic parameters)
Gil-Gómez et al.; (2011) [17]; PEDro: 6/10	WBB: 9; CR: 8	47 mean	Chronic; 1-2 years	Nonimmersive: WBB easy balance virtual rehabilitation	Auditory, visual	20 ses.; 1 h/d (3–5 d/w)	BBS, BBA, ART, TST, ST, 1MWT, 10MWT, TUG, 30SST
Fritz et al.; (2013) [18]; PEDro: 6/10	Game: 15; C: 13	66 mean	Chronic; 3-4 years	Nonimmersive and semi-immersive: WBB and play station	Auditory, visual	20 ses.; 1 h/d, 4 d/w	FMS, BBS, TUG, 6MWT, Dynamic Gait Index, 3MWT, Stroke Impact Scale
Cho and Lee; (2013) [19]; PEDro: 7/10	CP + TRWVR: 15; CP + TT: 15	64 mean	Chronic; 1-2 years	Semi-immersive: treadmill + screenshot of real-world video recording	Auditory, visual	18 ses.; 30 m/d, 3 d/w, 6 w	BBS, TUG, gait performance (GAITRite)
Park et al.; (2013) [20]; PEDro: 4/10	VR + CP: 8; CP: 8	47 mean	Chronic; 11 years	Immersive; VR-based postural control program (head-mounted display)	Visual	12 ses.; 30 min/d, 3 d/w, 4 w	10MWT, GAITRite (gait parameters)
Cho and Lee; (2014) [21]; PEDro: 7/10	CP + TRWVR: 15; CP + TT: 15	64 mean	Chronic; 1-2 years	Semi-immersive: treadmill + screenshot of real-world video recording	Auditory, visual	18 ses.; 30 m/d, 3 d/w, 6 w	BBS, TUG, Postural Sway Platform System, GAITRite

3MWT: 3-Minute Walking Test; 6MWT: 6-Minute Walking Test; 10MWT: 10-Meter Walking Test; 30SST: 30-Second Sit to Stand Test; ABC scale: activities-specific balance confidence; ART: Anterior Reach Test; BBA: Brunel Balance Assessment; BBS: Berg Balance Scale; BPM: Balance Performance Monitor; C: control (no intervention); CP: conventional physiotherapy; FAC: Functional Ambulatory Scale; FMS: Fugl-Meyer Scale; KP: knowledge of performance; KR: knowledge of results; MMAS: Modified Motor Assessment Scale; OVR: virtual obstacle training; PAM: Patient Activity Monitor, Ossur (walking activity); R: robot; ROT: real obstacles training; ST: Steeping Test; TRWVR: treadmill training based real-world video recording; TST: Timed Stair Test; TT: treadmill training; TUG: Timed Up Go; VRTT: virtual reality-based treadmill training; WAQ: Walking Ability Questionnaire; WBB: Wii Balance.