Teleneurorehabilitation program (virtual reality) for patients with balance disorders: descriptive study

Area of Science:

• Neurology
• Rehabilitation Medicine
• Virtual Reality Applications

Background:

• Balance disorders are prevalent in neurological and vestibular conditions.
• Virtual Reality (VR) is increasingly used in telerehabilitation for balance disorders.
• Current VR rehabilitation often lacks focus on reactive postural control and objective outcome measurement.

Purpose of the Study:

• To present a methodology for training selection and a clinical protocol for a VR-based telerehabilitation program.
• To address limitations in objective supervision and measurement of telerehabilitation programs for balance disorders.
• To improve patient autonomy in reacting to instability and provide precise, measurable rehabilitation objectives.

Main Methods:

• A descriptive study involving physiotherapist training on the RehaMetrics® platform.
• Interobserver reliability was assessed using the kappa statistic to evaluate agreement in exercise cluster selection.
• The protocol was applied to patients with sedentary trunk control and mild/normal cognitive levels.

Main Results:

• Expert physiotherapists demonstrated over 80% agreement in exercise selection (very good reliability), while novices showed 45% agreement (moderate reliability).
• Statistically significant improvements were observed in clinical outcomes, including Maximum Width Left Side (MWLS).
• The intervention involved an average of 485.81 minutes of training over 17 sessions across 4 weeks.

Conclusions:

• The developed VR telerehabilitation protocol exhibits excellent interobserver reliability among trained physiotherapists.
• Significant improvements in balance, gait functionality, walking distance, and cognition were noted post-intervention.
• VR telerehabilitation serves as an effective alternative for ensuring treatment continuity for patients with balance disorders.