Improved Balance and Gait in a 47-Year-Old Man with Post-Stroke Left Hemiplegia Following Virtual Reality-Based Real-Time Feedback : A Case Study

The purpose of this case report is to investigate the effects of real-time feedback from virtual reality gait training on the balance and gait abilities of a patient with post-stroke left hemiplegia. A 47-year-old male diagnosed with stroke caused by left basal ganglia intracerebral hemorrhage (ICH), resulting in right hemiplegia, participated in this case study. Notably, he exhibited hemiplegic symptoms on the right side. Physical therapy interventions included 30 minutes of virtual reality-based real-time feedback gait training, followed by 30 minutes of conventional physical therapy, consisting of Bobath, proprioceptive neuromuscular facilitation (PNF), range of motion exercises, stretching exercises, upper and lower extremity strengthening exercises, overground gait training, cycling, and treadmill gait training. The patient underwent a total of 60 minutes of training per session, conducted three times a week for eight weeks, amounting to a total of 24 sessions. Balance and gait ability were evaluated before the intervention, after four weeks, and after eight weeks. For the assessment of balance, the timed up and go test (TUG) and the berg balance scale (BBS) were utilized. Gait ability was evaluated using GaitRite. Following the intervention, the patient's BBS score improved from 41 to 45 in terms of balance ability, and the TUG result improved from 22.31 seconds to 19.85 seconds. In terms of gait ability, the 10-meter walk test result improved from 22.02 seconds to 19.65 seconds. The affected step length increased from 19.00 cm to 23 cm, while the stride length increased from 34.00 cm to 39 cm. Velocity improved from 1.0 km/h to 1.4 km/h, cadence increased from 50 steps per minute to 60 steps per minute, and single limb support improved from 22.8% of the gait cycle to 25.1% gait cycle. Virtual reality-based real-time feedback gait training had a positive impact on the rehabilitation of a patient with post-stroke left hemiplegia, demonstrating improvements in both balance and gait ability. These findings suggest that further studies are necessary to explore the broader effects of virtual reality-based real-time feedback gait training in patients with post-stroke left hemiplegia.