Effects of Virtual Reality–Augmented Balance Training on Sensory Organization and Attentional Demand for Postural Control in People With Parkinson Disease: A Randomized Controlled Trial

BACKGROUND: There is a lack of studies related to virtual reality (VR)-augmented balance training on postural control in people with Parkinson disease (PD). OBJECTIVE: The purposes of this study were: (1) to examine the effects of VR-augmented balance training on the sensory integration of postural control under varying attentional demands and (2) to compare the results with those of a conventional balance training (CB) group and an untrained control group. DESIGN: A longitudinal, randomized controlled trial was used. SETTING: The intervention was conducted in the clinic, and the assessment was performed in a research laboratory. PATIENTS: Forty-two people with PD (Hoehn and Yahr stages II-III) were recruited. INTERVENTION: The VR and CB groups received a 6-week balance training program. MEASUREMENTS: The sensory organization tests (SOTs) of computerized posturography with single- and dual-task conditions were conducted prior to training, after training, and at follow-up. Equilibrium scores, sensory ratios, and verbal reaction times (VRTs) were recorded. RESULTS: There were no significant differences in equilibrium scores or VRTs between the VR and CB groups. However, the equilibrium scores in SOT-6 (ie, unreliable vision and somatosensation) of the VR group increased significantly more than that of the control group after training. The equilibrium scores in SOT-5 (ie, unreliable somatosensation with eyes closed) of the CB group also increased significantly more than that of the control group after training. LIMITATIONS: The functional significance of the improvements in equilibrium scores in the SOTs was not known, and the sample size was small. CONCLUSIONS: Both VR and CB training improved sensory integration for postural control in people with PD, especially when they were deprived of sensory redundancy. However, the attentional demand for postural control was not changed after either VR or CB training.