Virtual Reality Telerehabilitation for Postural Instability in Parkinson’s Disease: A Multicenter, Single-Blind, Randomized, Controlled Trial

Table 1

TeleWii balance training program.

Name of exercise	Exercise description	Expected impact on mobility
Table tilt	Shift the body weight in all directions with feet placed in a fixed position. Make a plan of movements to tilt the virtual platform, bring the balls in the holes and go to the next level of difficulty	Improve the correct use of ankle and hip strategy during static condition. Improve the quick change of strategy from ankle to hip and vice versa
Penguin slide	Shift the body weight toward the right and left direction to bend the virtual ice platform, with feet placed in a fixed position. Make a plan of movements to catch as much fishes as possible	Improve the correct use of ankle and especially hip strategy during static condition
Balance bubble	Shift the body weight forward to move the avatar forward; lean left and right to steer	Improve the correct use of ankle and hip strategy during static condition. Improve the quick change of strategy from ankle to hip and vice versa
Ski slalom	Lean the body left and right to ski down a slalom course and pass between flags with your avatar	Improve the correct use of ankle and hip strategy during static condition. Improve the quick change of strategy from ankle to hip and vice versa. Improve the ability to orientate the trunk in the space
Skateboarding	Push off the ground with right/left foot to skate forward with your avatar, and lean left or right to turn; if the speed slows down, lean toward one side to pick up speed; jump off the virtual ramps by raising heels to perform a trick in midair	Improve the correct use of ankle, hip, and stepping strategy during quasi-static condition. Improve the quick change of strategy from ankle to hip or stepping and vice versa. Improve the ability to orientate the trunk in the space
Perfect 10	Shake hips back, front left, or right to add up to the given number with your avatar. The aim is to make a sum of 10	Improve the correct use of ankle and hip strategy during static condition. Improve the quick change of strategy from ankle to hip and vice versa. Improve the dual task performance (motor & cognitive task)
Tilt city	Tilt the Wii remote to move the virtual board at the top of the screen. Shift your body weight left and right to tilt the virtual boards at the bottom. Make a plan of movements to drop the balls into the matching colored pipe	Improve the correct use of hip strategy during static condition. Improve the coordination between upper and lower limbs (dual motor task)
Snowball fight	Shift your body weight right or left to move out your avatar from behind a protective barrier; use the Wii remote at the screen to throw snowballs; when throwing, watch out for incoming snowballs and avoid them by shifting your body weight	Improve the correct use of ankle and hip strategy during static condition. Improve the quick change of strategy from ankle to hip and vice versa. Improve the coordination between upper and lower limbs (dual motor task). Improve the attentional strategies to multiple stimuli
Rhythm parade	Stepping in place to move your avatar and wave the controller when scrolling icons coming from the top of the screen hit the circles place at the bottom	Improve the correct use of all strategies during static condition. Improve the quick change of strategy from hip to stepping and vice versa. Improve the coordination between upper and lower limbs (dual motor task)
Bird’s-eye bulls-eye	Stand on the board with feet placed in a fixed position. Flap the arms to land your avatar on the targets; lean in and flap to fly your avatar forward; stay centered on the board and flap to go higher with your avatar; shift the body weight right or left to turn; stop flapping to land your avatar on a target and to get a bonus; rack up bonus time and head for the finish; small flaps help hover; big flaps help to soar	Improve the correct use of ankle and hip strategy during static condition. Improve the quick change of strategy from ankle to hip and vice versa. Improve the coordination between upper and lower limbs, and between upper limbs (dual motor task)

CoM, center of mass; CoP, center of pressure. The exercises are listed in order of task difficulty starting from single-task through dual-task performance.