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Journal of NeuroEngineering and Rehabilitation
Published in: Journal of NeuroEngineering and Rehabilitation 1/2017

Open Access 01-12-2017 | Research

The role of virtual reality in improving motor performance as revealed by EEG: a randomized clinical trial

Authors: Rocco Salvatore Calabrò, Antonino Naro, Margherita Russo, Antonino Leo, Rosaria De Luca, Tina Balletta, Antonio Buda, Gianluca La Rosa, Alessia Bramanti, Placido Bramanti

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2017

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Abstract

Background

Many studies have demonstrated the usefulness of repetitive task practice by using robotic-assisted gait training (RAGT) devices, including Lokomat, for the treatment of lower limb paresis. Virtual reality (VR) has proved to be a valuable tool to improve neurorehabilitation training. The aim of our pilot randomized clinical trial was to understand the neurophysiological basis of motor function recovery induced by the association between RAGT (by using Lokomat device) and VR (an animated avatar in a 2D VR) by studying electroencephalographic (EEG) oscillations.

Methods

Twenty-four patients suffering from a first unilateral ischemic stroke in the chronic phase were randomized into two groups. One group performed 40 sessions of Lokomat with VR (RAGT + VR), whereas the other group underwent Lokomat without VR (RAGT-VR). The outcomes (clinical, kinematic, and EEG) were measured before and after the robotic intervention.

Results

As compared to the RAGT-VR group, all the patients of the RAGT + VR group improved in the Rivermead Mobility Index and Tinetti Performance Oriented Mobility Assessment. Moreover, they showed stronger event-related spectral perturbations in the high-γ and β bands and larger fronto-central cortical activations in the affected hemisphere.

Conclusions

The robotic-based rehabilitation combined with VR in patients with chronic hemiparesis induced an improvement in gait and balance. EEG data suggest that the use of VR may entrain several brain areas (probably encompassing the mirror neuron system) involved in motor planning and learning, thus leading to an enhanced motor performance.

Trial registration

Retrospectively registered in Clinical Trials on 21-11-2016, n.NCT02971371.
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Metadata
Title
The role of virtual reality in improving motor performance as revealed by EEG: a randomized clinical trial
Authors
Rocco Salvatore Calabrò
Antonino Naro
Margherita Russo
Antonino Leo
Rosaria De Luca
Tina Balletta
Antonio Buda
Gianluca La Rosa
Alessia Bramanti
Placido Bramanti
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Journal of NeuroEngineering and Rehabilitation / Issue 1/2017
Electronic ISSN: 1743-0003
DOI
https://doi.org/10.1186/s12984-017-0268-4

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