Virtual Reality-Guided Reaching During Treadmill Walking Alters Dynamic Stability in People with Stroke

Area of Science:

• Neurorehabilitation
• Biomechanics
• Virtual Reality (VR) applications

Background:

• Stroke survivors often experience impaired dynamic balance during gait.
• Virtual reality (VR) offers a promising platform for gait rehabilitation.
• Understanding balance challenges during complex tasks in VR is crucial for effective therapy.

Purpose of the Study:

• To investigate the impact of goal-directed reaching on dynamic balance in stroke survivors during VR-based treadmill walking.
• To quantify dynamic balance using frontal-plane whole-body angular momentum (H).

Main Methods:

• Sixteen individuals with stroke performed a VR-based reaching task while walking on a treadmill.
• Markerless motion capture (Theia3D) collected kinematic data.
• Frontal-plane range of angular momentum (H_R) and segmental contributions were analyzed.

Main Results:

• Frontal-plane H_R significantly increased during reaching strides compared to non-reaching strides across various walking speeds.
• Balance demands were higher for reaching contralateral targets.
• The trunk and reaching arm were primary contributors to altered angular momentum during reaching.

Conclusions:

• Goal-directed reaching during VR treadmill walking significantly increases frontal-plane balance demands for stroke survivors.
• Trunk and reaching arm movements are key factors influencing balance during this task.
• Task-specific, internally generated challenges within VR environments show potential for gait rehabilitation strategies.