Clinical experience using a 5-week treadmill training program with virtual reality to enhance gait in an ambulatory physical therapy service

Overview

Currently, the literature describes safe gait as a complex task that relies on both motor and cognitive resources. The use of virtual reality (VR) to enhance gait during treadmill training has demonstrated positive effects on mobility, balance, and fall risk among elderly people and individuals with neurological disorders. Although this type of training has been described as a viable research tool, it has not been routinely used in clinical practice. In a recent study, VR was used to develop an adjunct training method for physical therapists to use in their clinical setting.

Methods:

This article describes the initial clinical experience of applying a 5-week VR treadmill training clinical service for improving gait and mobility for people with a history of falls, poor mobility, or postural instability.

Objective: 

A review of the clinical records of the first 60 patients to complete the VR treadmill training program was conducted. Training took place 3 times per week for 5 weeks, lasting approximately 1 hour each time and involving walking on a treadmill while negotiating virtual obstacles. Timed “Up & Go” Test (TUG), Two-Minute Walk Test (2MWT), and Four Square Step Test (FSST) were the main outcome measures compared across time.

Findings:

During the 5 weeks of treadmill training, the time to complete the TUG decreased by 10.3%, the distance walked during the 2MWT increased by 9.5%, and performance on the FSST improved by 13%.

Limitations:

Study limitations include the use of a retrospective analysis without a control group and the lack of objective cognitive testing.

Conclusions:

Compared to treadmill training alone, treadmill training plus virtual reality reduced fall rates in a diverse group of older adults at high fall risk.