Authors: (including presenting author): :
Ho CM, Kwok WC, Leung SK, Mak HY, Wong WC, Tsui SKA
Affiliation: :
Physiotherapy Department, TWGHs Wong Tai Sin Hospital
Keyword 1: :
Virtual Reality
Keyword 5: :
Rehabilitation
Introduction: :
Post-stroke balance impairment is common and significantly limits mobility and functional independence. As retrieved from Clinical Data Analysis and Reporting System, 26% of stroke patients initially admitted to TWGHs Wong Tai Sin Hospital (WTSH) in 2025 were assisted and supervised walkers. Early and intensive balance training is essential for these patients to regain functional independence, reduce fall risk and facilitate community reintegration. Virtual reality (VR)-based balance training using KinesiQ provides interactive visual feedback and replicates real-life scenarios using a virtual environment and robotic platform. These features potentially enhance motor learning and patient adherence, which are critical in the time-sensitive window of in-patient rehabilitation.
Objectives: :
This study aims to establish evidence on the feasibility, patient experience and clinical outcomes on balance, mobility and lower limb muscle strength of a one-week VR-based balance training programme in stroke patients during in-patient rehabilitation.
Methodology: :
10 stroke patients, with Modified Functional Ambulatory Category (MFAC) 4 or above, under the neurological rehabilitation programme in WTSH were recruited on a voluntary basis. In addition to the standard physiotherapy programme, the participants received 5 sessions of KinesiQ balance training (20 minutes each), consisting of VR-based activities. Outcome measures were collected before and after intervention, including Berg Balance Scale (BBS), Elderly Mobility Scale (EMS), Modified Rivermead Mobility Index (MRMI), 6-meter timed walk, functional reach and hand-held dynamometry of lower limb muscle groups. Patient satisfaction was recorded after intervention using a customized Likert-scale survey.
Result & Outcome: :
Significant improvements in balance performance were observed with BBS increasing from 32 to 45.8 (p< 0.001) and functional reach from 17.22 to 22.50 centimeters (p=0.012). Mobility also demonstrated significant improvements with EMS increasing from 15.9 to 18.2 (p=0.007) and MRMI from 31.5 to 36 (p=0.008). Strength gains were seen in knee extensors (p=0.001), hip abductors (p=0.014), ankle dorsiflexors (p=0.006) and ankle plantarflexors (p< 0.001). No significant change was detected in 6-meter timed walk (p=0.232). Patient feedback was positive, with high safety perception (4.4/5), good perceived effectiveness (4.0/5) and positive overall satisfaction (3.8/5).
VR-based balance training using KinesiQ appears to be safe, well-accepted and effective in producing short-term improvements in balance, mobility and lower limb muscle strength in subacute stroke patients. These positive findings justify ongoing recruitment and future between-group analysis to evaluate its comparative benefits over conventional balance training systems in accelerating functional recovery.
