Visuo-Vestibular Land: Training per l’equilibrio mediante realtà virtuale immersiva in paziento con ictus
Autori
Diego Piatti* (Santa Lucia Foundation, Scientific Institute for Research and Health Care, 00179 Rome, Italy) [*these authors contributed equally]
Jacopo Piermaria* (Santa Lucia Foundation, Scientific Institute for Research and Health Care, 00179 Rome, Italy) [*these authors contributed equally]
Sara De Angelis (Santa Lucia Foundation, Scientific Institute for Research and Health Care, 00179 Rome, Italy)
Gianluca Paolocci (Santa Lucia Foundation, Scientific Institute for Research and Health Care, 00179 Rome, Italy)
Matteo Marucci (Department of Psychology, Sapienza University of Rome, Rome, Italy; Laboratory of Neuroscience and Applied Technology, Santa Lucia Foundation IRCCS, Rome, Italy)
Roberta Annicchiarico (Santa Lucia Foundation, Scientific Institute for Research and Health Care, 00179 Rome, Italy)
Viviana Betti (Department of Psychology, Sapienza University of Rome, Rome, Italy; Laboratory of Neuroscience and Applied Technology, Santa Lucia Foundation IRCCS, Rome, Italy)
Marco Tramontano (Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, 40138, Bologna, Italy; Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138, Bologna, Italy)
Background and aims
Exposure to natural environments has been shown to have a positive and wide-ranging impact on well-being. Virtual Reality (VR) technology offers an innovative way to simulate naturalistic settings, helping individuals overcome barriers that may prevent them from accessing real-world nature (1). Vestibular Physical Therapy (VPT) is a rehabilitative approach used to address balance impairments also in people with stroke (2). This study aims to evaluate the feasibility of delivering VPT through immersive VR using ecologically valid scenarios in people with stroke.
Methods
Nine individuals with stroke were randomized into two groups. Participants in the experimental group underwent dynamic training using immersive VR scenarios that exposed them to visuo-vestibular stimuli in ecologically valid conditions. For example, while virtually walking
through a market environment, they were unexpectedly exposed to visuo-vestibular perturbations. In the control group, patients engaged in similar walking activities within a VR environment that did not include any visuo-vestibular stimuli. Assessments were conducted at baseline, after 12 training sessions, and one month post-intervention. Outcome measures included inertial sensor data, validated clinical balance scales, and questionnaires designed to assess the feasibility and user satisfaction of the protocol.
Results
Feasibility and acceptance were found to be satisfactory, as the VR experience was well-tolerated and no adverse side effects were reported. Patient-reported questionnaires indicated that this type of training could be effectively integrated into clinical practice.
Conclusion
This feasibility study suggests that the proposed VR-based training is safe, well-tolerated, and has the potential to be expanded for the development of ecologically valid rehabilitation protocols. Preliminary results indicate that the selected assessment tools are appropriate for
evaluating its effectiveness. These findings support the feasibility of conducting a randomized controlled clinical trial to further investigate the efficacy of this novel neurorehabilitation approach.
REFERENCES
1) Pardini, S., Gabrielli, S., Gios, L., Dianti, M., Mayora-Ibarra, O., Appel, L., Olivetto, S., Torres, A., Rigatti, P., Trentini, E., Leonardelli, L., Bernardi, M., Lucianer, M., Forti, S., & Novara, C. (2023). Customized virtual reality naturalistic scenarios promoting engagement and relaxation in patients with cognitive impairment: a proof-of-concept mixed-methods study. Scientific reports, 13(1), 20516. https://doi.org/10.1038/s41598-023-47876-1
2) Tramontano, M., Russo, V., Spitoni, G. F., Ciancarelli, I., Paolucci, S., Manzari, L., & Morone, G. (2021). Efficacy of Vestibular Rehabilitation in Patients With Neurologic Disorders: A Systematic Review. Archives of physical medicine and rehabilitation, 102(7), 1379–1389.
https://doi.org/10.1016/j.apmr.2020.11.017