{"id":4370,"date":"2023-01-31T10:46:17","date_gmt":"2023-01-31T10:46:17","guid":{"rendered":"https:\/\/www.gaitbetter.com\/?p=4370"},"modified":"2025-07-29T13:48:06","modified_gmt":"2025-07-29T13:48:06","slug":"a-vr-high-intensity-gait-training-in-stroke-patients-a-case-series","status":"publish","type":"post","link":"https:\/\/www.gaitbetter.com\/de\/a-vr-high-intensity-gait-training-in-stroke-patients-a-case-series\/","title":{"rendered":"VR high intensity gait training in stroke patients a case series"},"content":{"rendered":"
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t

The Use of Virtual Reality Treadmill Training to Increase Dosage and Meet
High Intensity Gait Training Goals: A Case Series<\/a><\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

Faye Bronstein PT, DPT, NCS<\/i><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

Overview<\/b><\/h4>

Early intensive gait training is an established best practice in patients with chronic stroke and has been shown to have significant benefits in patients with subacute strokes. Best practice guidelines dictate training at a 60-80% heart rate reserve (HRR) for as long as tolerated within a treatment session, which can be challenging in the inpatient rehabilitation setting. Particular challenges include sustaining the target heart rate (HR) for appropriate periods and maximizing the amount of time spent stepping within a treatment session.\u00a0<\/span><\/p>

The use of virtual reality (VR) training coupled with gait training has shown\u00a0benefits in gait outcomes, balance outcomes and lower extremity\u00a0strengthening5. VR training has been used as a tool to distract and\u00a0engage patients, allowing for better participation and motivation. To date,\u00a0there are no studies investigating the use of VR coupled gait training as an\u00a0adjunct to meet the HR and dosage goals recommended for\u00a0<\/span>high intensity\u00a0gait training (HIGT)<\/a>.\u00a0<\/span><\/p>

This case series will look at patients with subacute\u00a0stroke in the inpatient rehabilitation setting who are participating in a HIST\u00a0protocol and the effects of VR coupled gait training in achieving the\u00a0recommended parameters during gait training.<\/span><\/p>

Subjects:<\/b><\/p>

This case series looks at 3 patients with subacute strokes who were\u00a0medically cleared to participate in HIGT during their inpatient rehabilitation\u00a0<\/span>stay. All patients participated in physical therapy for 60 minute treatment\u00a0<\/span>sessions at least 5 days a week. All patients were ambulatory with assist\u00a0<\/span>ranging from minimal assist of 1 therapist to moderate assist of 2\u00a0<\/span>therapists. Gait training was prioritized in each treatment session which\u00a0<\/span>im Vordergrund und war sowohl an den therapeutischen als auch an den individuellen Zielen der Patient:innen ausgerichtet.<\/span><\/p>

Results:\u00a0<\/b><\/p>

On average, the patients ambulated 3:45 longer when completing treadmill\u00a0training with VR than without VR.\u00a0<\/span><\/p>

The patients average heart rate was 7.6\u00a0<\/span>beats per minute faster when using VR during treadmill training. Patient 3\u00a0<\/span>specifically demonstrated the greatest differences, ambulating over 6 minutes\u00a0<\/span>more on average per gait trial and ambulating at a significantly higher intensity\u00a0<\/span>Unterst\u00fctzung h\u00e4tte dieser Patient m\u00f6glicherweise nicht die erforderliche Trainingsintensit\u00e4t und -dauer\u00a0<\/span>erreicht, die f\u00fcr\u00a0<\/span>system, this patient may not have achieved the intensity and time of the\u00a0<\/span>stepping practice needed for the recommended gait protocol.\u00a0<\/span><\/p>

All patients\u00a0<\/span>tolerated treadmill training, with and without the VR, without adverse events.\u00a0<\/span>2 of the 3 patients reported enjoying gait training more with the VR than\u00a0<\/span>without, while one patient reported no preference between VR versus no VR.<\/span><\/p>

Conclusions:\u00a0<\/b><\/p>

The use of VR appears to be an effective way to increase dosage and achieve\u00a0target heart rate when working toward goals of HIGT. VR can engage patients,\u00a0<\/span>improve buy in and add variability during gait training, which may result in\u00a0<\/span>patients working at higher intensities for longer periods of time. The use of VR\u00a0<\/span>may be a good adjunct tool if there is difficulty achieving HIGT principles when\u00a0<\/span>treadmill training or over ground training alone is not affective.\u00a0<\/span><\/p>

Limitations to this\u00a0<\/span>case series include a small sample size, varying severity of stroke and\u00a0<\/span>endurance, and no control group. Further investigation is needed to understand\u00a0<\/span>if using VR during gait training sessions is a superior tool than without to achieve\u00a0<\/span>HIGT goals.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

* GaitBetter was used in this study<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tDOWNLOAD THE CASE SERIES POSTER<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"

The Use of Virtual Reality Treadmill Training to Increase Dosage and MeetHigh Intensity Gait Training Goals: A Case Series Faye Bronstein PT, DPT, NCS Overview Early intensive gait training is an established best practice in patients with chronic stroke and has been shown to have significant benefits in patients with..<\/p>","protected":false},"author":7,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[32],"tags":[],"class_list":["post-4370","post","type-post","status-publish","format-standard","hentry","category-publications"],"_links":{"self":[{"href":"https:\/\/www.gaitbetter.com\/de\/wp-json\/wp\/v2\/posts\/4370","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.gaitbetter.com\/de\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.gaitbetter.com\/de\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.gaitbetter.com\/de\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/www.gaitbetter.com\/de\/wp-json\/wp\/v2\/comments?post=4370"}],"version-history":[{"count":5,"href":"https:\/\/www.gaitbetter.com\/de\/wp-json\/wp\/v2\/posts\/4370\/revisions"}],"predecessor-version":[{"id":68912,"href":"https:\/\/www.gaitbetter.com\/de\/wp-json\/wp\/v2\/posts\/4370\/revisions\/68912"}],"wp:attachment":[{"href":"https:\/\/www.gaitbetter.com\/de\/wp-json\/wp\/v2\/media?parent=4370"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.gaitbetter.com\/de\/wp-json\/wp\/v2\/categories?post=4370"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.gaitbetter.com\/de\/wp-json\/wp\/v2\/tags?post=4370"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}