Effect of Visual Modification by Video See-Through Augmented Reality with REHA-Glasses on Postural Verticality in Individuals with Post-Stroke Lateropulsion

Objectives To examine whether post-stroke lateropulsion can be corrected to the upright position by wearing REHA-glasses, which provide the wearer with front-view images rotated based on body tilt. Methods A prospective, open-label, single-arm, exploratory, interventional study for individuals with first-ever acute stroke and spontaneous body posture rated ≥ 0.75 on the Scale for Contraversive Pushing (SCP) was conducted in a single center in Japan. The intervention was performed by three physical therapists who understood the study protocol. When the participants wore REHA-glasses, the therapist rotated the visual field of view with the intent of moving the participants’ position to an upright stance. Differences in assessment between therapists were resolved by mutual agreement. The primary outcome was the change in the total SCP score between the pre-wearing and wearing periods. Adverse events included falling, cybersickness symptoms, deterioration of neurological symptoms, and mechanical problems. Results Twenty-four participants (mean 67.6 years) were enrolled. The total SCP score was lower during wearing than during pre-wearing: mean 0.62 (standard deviation: 0.96) vs. 2.26 (1.13); median 0.1 (interquartile range: 0–0.9) vs. 2.0 (1.3–2.5); mean difference 1.64 (95% confidence interval: 1.29–1.97), respectively, p < 0.001, Cohen's dz = 2.04. Mechanical problems, due to damage to the connection port of the headset, was the only adverse event, which did not endanger the participants’ safety. Conclusions Post-stroke lateropulsion was improved by modulating visual input using REHA-glasses.