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| Author, year, Title | Study type, PEDro score | Participants | VR type | Device/software/tools/protocol | Inclusion and exclusion criteria | Adverse events | H&Y score | Cognitive scales | Other outcomes | Evaluation times | Objective of the study | Conclusions |
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Bekkers et al., 2020 [25]
Do patients with Parkinson’s disease with freezing of gait respond differently than those without to treadmill training augmented by virtual reality? | RCT, 6 | No: 121 (FOG+ = 77, FOG− = 44)
VRG: 62
TG: 59
Age
VRG: 71.06
TG: 70.86
Disease duration, years
VRG: 9.05
TG: 9.55 | Nonimmersive VR | VRG: treadmill with simulated obstacles in a virtual environment
TG: treadmill
Both treatments, lasting 45 minutes, were carried out 3 times a week for 6 weeks | I.C: age 60–90; H&Y II-III; anti-Parkinson therapy; walking for 5 minutes without assistance; adequate vision and hearing; 2 or more falls in the previous 6 months
E.C: psychiatric comorbidities; MMSE <24; history of stroke, head injury, or other neurological disease other than PD; orthopaedic or rheumatic diseases; acute lower back pain or pain in limbs, peripheral neuropathy, inability to participate in training. | — | VRG: 2.42
TG: 2.49 | MMSE: VRG = 27.76 (1.7) TG = 28.34 (1.5)
MoCA: VRG = 23.85 (4.5) TG = 24.27 (3.5) | Primary: balance and falls: mini-BEST
Secondary: number of falls NFOG-Q TMT-B SPPB FSST FES-I PASE MMSE MoCA UPDRS-III | T0 (baseline); T1 (after 1 week);
T2 (after 6 weeks)
T3 (6 months follow up) | To show a reduction in falls and improvement in balance following training on the treadmill with virtual reality compared to the treadmill alone, highlighting any differences between patients with and without FOG. | FOG patients improved balance and risk of falls in treadmill training both with and without VR compared to non-FOG patients |
Del Din et al., 2020 [26]
Falls risk in relation to activity exposure in high-risk older adults | RCT, 5 | No tot = 282, PD = 128
Age 71.68 | Nonimmersive VR | VRG: treadmill associated with VR in elderly patients/with MCI/PD
TG: treadmill
Both treatments, lasting 40 minutes, were carried out 3 times a week for 6 weeks. | I.C: age 60–90; able to walk for 5 minutes without assistance; stable therapy the month before; 2 or more falls in the previous six months
E.C: psychiatric comorbidities; history of stroke, brain damage and other neurological disorders; acute lower back pain; rheumatic or orthopaedic diseases; MMSE <21 | — | 48%: 2 10%: 2.5 42%: 3
Mean MP = 2.47 | MMSE (MP) 28.07 (1.68) | FRA index (Measure of the incidence of falls corrected for exposure) | T0 (pre-treatment);
T1 (after 1 week)
T2 (after 1 month)
T3 (after 6 months) | To study the relationship between gait (exposure to falling risk) and fall rates before and after a treadmill exercise program with and without VR (V-TIME) | V-TIME intervention successfully reduced the risk of falling by maintaining walking activity levels in different groups of elderly people at risk of falling |
Feng et al., 2019 [27]
Virtual reality rehabilitation versus conventional physical therapy for improving balance and gait in Parkinson’s disease patients: a randomized controlled trial | RCT, 7 | No: 28tot
VRG: 14
TG: 14
Age
VRG: 67.47
TG: 66.93 | Nonimmersive VR | VRG: perform game-based actions with a standard VR device
TG: conventional treatment
45 treatment, once a day, 5 times a week for 12 weeks | I.C: H&Y 2.5/4; age 50–70; signed informed consent
E.C: other causes of tremor; severe bone or joint disease; visual or hearing disturbances; inability to cooperate in the study | — | VRG: 3.03
TG: 2.97 | MMSE: VRG = 27.07 ± 2.09;
TG = 26.29 ± 2.49
Education received (years)
VRG: 10.47
TG: 9.93 | BBS TUG UPDRS III FGA | T0 (baseline)
T1 (after 12 weeks) | Studying the effects of virtual reality on balance and walking in patients with PD | Rehabilitation with VR improved outcomes compared to traditional treatment (except for UPDRS where no significant differences were noted) |
Ferraz et al., 2018 [17]
The effects of functional training, bicycle exercise, and exergaming on walking capacity of elderly patients with Parkinson disease: a pilot randomized controlled single-blinded trial | Pilot RCT, 7 | No: 62
TG1: 22
TG2: 20
VRG: 20
Age:
TG1: 71
TG2: 67
VRG: 67
Disease duration, years:
G1: 4
G2: 6
G3: 4 | Exergame (nonimmersive VR) | VRG: training with “Kinect Adventures” video game (Xbox 360) TG1: functional training TG2: cycling exercise. 50′ treatment, 3 times a week, for 8 weeks | I.C: age ≥ 60; regular use of therapy; H&Y II-III walking without aids
E.C: visual and hearing impairment; parkinsonian syndromes other than PD; orthopaedic diseases limiting physical activity; chronic uncontrolled diseases; cardiovascular disease; use of alcohol or toxic substances; contraindications to physical activity; practiced physical activity programs in the past 6 months; or participate in endurance training in the previous 12 months | — | TG1: 2.50 (2.5–3)
TG2: 2.50 (2-3)
VRG: 2.50 (2–2.5) | MMSE
TG1: 27.00 (24.75–28.00)
TG2: 27.00 (25.00–29.00)
VRG: 27.00 (25.00–28.00)
Education received (years):
TG1: 8.00
TG2: 9.50
VRG: 8.00 | Primary: 6 MWT
Secondary: 10 MWT SRT
Body mass index MPQ-39
WHODAS 2.0 GDS | T0 (baseline)
T1 (after 8 weeks) | Compare the effects of functional training, cycling and exergaming on walking ability in elderly patients with PD | Exergame training has achieved similar results to traditional treatments in improving gait; all three strategies are recommended, considering patients’ motivation |
Gandolfi et al., 2017 [28]
Virtual reality telerehabilitation for postural instability in Parkinson’s disease: a multicenter, single-blind, randomized, controlled trial | RCT, 6 | No: 76
VRG: 38 TG: 38
Age VRG: 67.45
TG: 69.84
Disease duration, (years)
VRG: 6.16
TG: 7.47 | VR nonimmersive | VRG: treatment with “Wii fit gaming system and balance board” at home, supervised via Skype by a physiotherapist TG: in-clinic sensory integration balance training (SIBT)
50′ treatment, 3 times a week for 7 consecutive weeks | I.C: age > 18; H&Y 2.5–3; stable therapy the month before; can perform postural transfer and stand for 10 minutes; presence of caregivers
E.C: cardiovascular, orthopedic and otovestibular disorders; visual or neurological conditions interfering with balance; severe dyskinesia or on-off fluctuations; MMSE <24; depression | — | VRG: 2.5
TG: 2.5 | MMSE
VRG = 26.77 (1.48)
TG = 28.64 (6.96) | Walking/balance
Primary: BBS
Secondary: ABC 10 MWT DGI MPQ-8 | T0 (baseline)
T1 (after treatment)
T2 (after 1 month) | Compare the improvements in postural stability after balance training with VR at home remotely supervised and in-clinic. balance training with sensory integration | Use of VR at home (TeleWii) is a valid alternative to conventional rehabilitation to reduce postural instability in patients with PD (H&Y 2.5–3) |
van den Heuvel et al., 2014 [29]
Effects of augmented visual feedback during balance training in Parkinson’s disease: a pilot randomized clinical trial | Pilot RCT, 8 | No: 33
VRG: 17
TG: 16
Age:
VRG: 66.3 (6.39)
TG: 68.8 (9.68)
Disease duration, (years)
VRG: 9
TG: 8.8 | Nonimmersive VR | VRG: interactive balance games with augmented visual feedback via an LCD monitor connected to a PC, a force plate, and an inertial sensor TG: conventional treatment
10 treatment sessions of 60′, for 5 weeks | I.C: H&Y 2–3; able to participate in both training programs; verbal and written informed consent
E.C: other neurological, orthopaedic, or cardiopulmonary diseases that prevent participation in the study; MMSE <24; recent change in dopaminergic therapy; cognitive, visual or speech problems that prevent participation | — | VRG: 2.5
TG: 2.5 | MMSE
VRG: 29
TG: 28 | Primary: FRT
Secondary: BBS H&Y UPDRS (I, II, III, IV) FES MPQ-39 HAD Multidimensional Fatigue inventory | T0 (baseline)
T1 (after 6 weeks)
T2 (after 12 weeks follow up) | Investigate whether a balance training program that uses augmented visual feedback is feasible, safe, and more effective than conventional balance training in improving postural control in PD patients | The use of augmented visual feedback in a group setting is safe and feasible to provide therapeutic balance training for patients with PD, even if no more effective than conventional therapy |
van der Kolk et al., 2019 [30]
Effectiveness of home-based and remotely supervised aerobic exercise in Parkinson’s disease: a double-blind, randomised controlled trial | RCT, 7 | No: 130
VRG:65
TG:65
Età VRG: 59.3
TG: 59.4
Disease duration, (years)
VRG: 3.41
TG: 3.16 | Nonimmersive VR | VRG: aerobic pedalling exercises at home (30′–45′at least 3 times a week) enriched with virtual reality software and real-life videos to create an exergaming experience
TG: stretching and relaxation (30′, 3 times a week) | I.C: H&Y>/= 2; practice less than the recommended physical activity for older adults; age 30–75; stable dopaminergic therapy
E.C: beta-blocker or antipsychotic drugs; neurological, orthopaedic or heart problems; psychiatric illness; MMSE <24 | Arthralgia/back pain (VRG = 2)
Palpitations (VRG = 4) | VRG:4
TG: 3 | MoCA
VRG.: 26.3. (2.2)
TG: 26.3 (2.5)
Education received (years):
VRG.: 15.1 (4.0)
TG: 16.1 (4.5) | Primary: MSD-UPDRS III (off)
Secondary: VO2 UPDRS III (on) UPDRS IV
Number of falls, 6 MWT TUG mini-BEST
Pegboard FTT MPQ-39 HADS SCOPA FSS TMT MoCA | T0 (baseline)
T1(after 6 months) | Evaluate the effectiveness of aerobic exercise, gamified, and performed at home, to promote therapy adherence and relieve motor symptoms in patients with PD | The study provides level 1 evidence that aerobic exercise alleviates motor symptoms in Parkinson’s disease and improves cardiovascular fitness |
Liao et al., 2015 [31]
Virtual reality-based training to improve obstacle crossing performance and dynamic balance in patieshewidmernts with Parkinson’s disease. | RCT, 7 | No: 36
VRG: 12
TG: 12
GC:12
Age
VRG: 67.3
TG: 65.1
CG: 64.6
Disease duration, (years):
VRG: 7.9
TG: 6.9
CG: 6.4 | Nonimmersive VR | VRG: VR exercises with Wii Fit Plus games and Wii Fit balance board
TG: traditional treatment (stretching, strengthening, balance)
CG: fall prevention education
12 treatment sessions of 45 '(+15' treadmill in VRG and TG), 2 times a week for 6 weeks | I.C: H&Y 1–3; autonomous walking without aids; stable therapy; MMSE>/= 24
E.C: unstable medical conditions; other neurological, cardiopulmonary, orthopaedic diseases; history of seizures; pacemaker; visual impairment | No adverse events | CG:1.9
TG: 2
VRG: 2 | MMSE
VRG: 29.5 (0.7)
TG: 29.8 (0.3)
CG:29.7 (0.6) | Primary: performance overcoming obstacles with “Liberty system” Dynamic balance with “balance master system”
Secondary SOT MPQ-39 FES-I) TUG | T0 (baseline)
T1(after 1 day)
T2(30 days after treatment -follow up) | Examine the effects of virtual reality-based exercise on overcoming obstacles in patients with Parkinson’s | VR with Wii, as part of a multi-faceted workout, is effective in improving performance when overcoming obstacles, dynamic balance, functional capacity, and quality of life in patients with PD |
Liao et al., 2015 (b) [32]
VR-based Wii fit training in improving muscle strength, sensory integration ability and walking abilities in patients with MP | RCT, 7 | No = 36
VRG: 12
TG: 12
GC: 12
Age
VRG: 67.3
TG: 65.1
CG: 64.6
Disease duration, (years)
VRG: 7.9
TG: 6.9
CG: 6.4 | Nonimmersive VR | VRG: exercises with Wii Fit and treadmill
TG: conventional training and treadmill
CG: fall prevention education 12 sessions, twice per week, for 6 weeks | I.C.: H&Y 1–3; autonomous walking without aids; stable therapy; MMSE ≥ 24
E.C: unstable medical conditions; other neurological, cardiopulmonary, orthopaedic diseases; pacemaker; | — | CG: 1.9
TG: 2
VRG: 2 | MMSE
VRG: 29.5
TG: 29.8
CG: 29.7 | Gait: GAITRite FGA
Muscle strength: dynamometer
Sensory integration skills: SOT | T0 (baseline)
T1 (after 6 weeks)
T2 (after 1 month-follow up) | Examine the effects of virtual reality-based training in improving muscle strength, sensory integration capacity and walking in patients with PD | Wii training is as useful as traditional training in improving outcomes, and these improvements have persisted for at least a month. It is therefore suggested that Wii training be implemented in patients with PD |
Ma et al., 2011 [33]
Effects of virtual reality training on functional reaching movements in people with Parkinson’s disease: a randomized controlled pilot trial | Pilot RCT, 5 | No: 33
VRG: 17
TG:
Age
VRG: 64.77
TG: 68.13
Disease duration, (years)
VRG: 5.32
TG: 5.16 | Immersive VR | VRG: reach 60 moving balls with your right-hand using VR system and polarized glasses
TG: roll 60 wooden cylinders with your left hand. | I.C: H&Y 2–3; Age 50–75; stable therapy; MMSE ≥ 24. Normal sight and hearing; right-handed to self-assessment
E.C: other neurological conditions besides PD; musculoskeletal disorders impairing UL movements; | Fatigue (VRG = 1) | VRG: 2
TG: 2 | MMSE
VRG: 27.24 (3.09)
TG: 26.31 (2.52) | Success rates of the required task (catching the ball)
Kinematic data | T0 (baseline)
T1 (After treatment) | To investigate whether practising with virtual moving targets would improve motor performance in people with Parkinson’s disease | A short training program with VR improved speed of movement and accuracy in reaching real fixed objects. However, the transfer effect was minimal in reaching real moving objects |
Maidan et al., 2017 [34]
Disparate effects of training on brain activation in Parkinson disease | RCT, 4 | No: 34
VRG: 17
TG: 17
Age
VRG: 71.2
TG: 71.5
Disease duration, (years)
VRG: 7.9
TG: 11.6 | Nonimmersive VR | VRG: VR associated treadmill
TG: treadmill only 18 Sessions 3 times a week for 6 weeks | I.C: age 60–90; H&Y 1–3; ability to walk independently for at least 5 minutes; anti Parkinson therapy
E.C: MRI contraindications; psychiatric comorbidities; MMSE <24; other neurological disorders besides PD; orthopaedic problems, unstable therapy | — | — | MMSE
VRG: 27.8 (0.4)
TG: 28.3 (0.5)
MoCA
VRG: 22.9 (0.9)
TG: 21.9 (0.8)
Global cognitive score
VRG: 89.7 (2.7)
TG: 88.4 (2.6)
Attention VRG: 88 (4.2)
TG: 84.1 (4.2)
Executive functions
VRG: 87.5 (2.2)
TG: 83.4 (3.2) | fMRI assessment
Step parameters
MoCa Computerized cognitive test battery | T0 (baseline)
T1 (after 7 weeks) | Compare the effects of treadmill training with virtual reality and treadmill training alone on brain activation in patients with Parkinson’s disease | The results suggest that the task-specific exercise provided by VR led to experience-dependent neuroplasticity and reduced the usefulness of activating compensatory cognitive functions resulting in greater automaticity. Training with VR has improved both motor and cognitive aspects of the altered front-striatal circuit |
Maidan et al., 2018 [16]
Evidence for differential effects of 2 forms of exercise on prefrontal plasticity during walking in Parkinson’s disease | RCT, 4 | No: 64
VRG: 30
TG: 34
Age
VRG: 70.1
TG: 73.1
Disease duration, (years)
VRG: 8.9
TG: 9.7 | Nonimmersive VR | VRG: treadmill training with virtual obstacles on a screen ahead
TG: treadmill 45' treatment, 3 times a week for 6 weeks | I.C: age 60–90; H&Y 2–3; autonomous walking for at least 5 minutes; anti-Parkinson therapy
E.C: psychiatric comorbidities; MMSE <24; performance-impairing neurological diseases; orthopaedic problems that could compromise walking; unstable medical conditions including cardiovascular instability | — | — | MMSE
VRG: 28.2 (0.3)
TG: 28.3 (0.3) | Deambulation (electronic gangway with pressure sensors)
Prefrontal activation (functional near infrared spectroscopy—fNIRS) | — | Investigate whether the VR-paired treadmill and the treadmill alone differently affect prefrontal activation and whether this could explain the differences in fall rates after surgery | Providing a combined cognitive-motor training intervention may result in specific changes in prefrontal activation patterns that improve functional abilities, reduce falls and the risk of falling, which in turn could slow deterioration in patients with PD |
Mirelman et al., 2016 [35]
Addition of a non-immersive virtual reality component to treadmill training to reduce fall risk in older adults (V-TIME): a randomised controlled trial | RCT, 8 | No: 302
(MP: 130)
VRG: 154
TG: 148
Age (elderly and PD)
VRG:
74.2
TG: 73.3 | Nonimmersive VR | VRG: VR associated treadmill (elderly and with PD)
TG: treadmill training 45' sessions, 3 times a week for 6 weeks | I.C: age 60–90; walking without assistance for at least 5 minutes; stable therapy in the previous month; 2 or more falls in the previous 6 months; clinical dementia rating scale = 0.5; H&Y 2-3; anti Parkinson therapy
E.C: psychiatric comorbidities; history of stroke, brain damage and other neurological disorders; acute lower back pain; rheumatic or orthopaedic diseases; MMSE <24 | Present but not related to the study | — | MMSE
VRG: 27.8 (1.8)
TG: 28.2 (1.7)
Education received (years)
VRG: 13.1 (4.0)
TG: 12.9 (3.9) | Primary: rate of accidental falls
Secondary: gait speed/variability 2 MWT SPPB NeuroTrax Corp SF-36 | T0 (baseline)
T1 (after training)
T3 (after 6 months) | Test the hypothesis that a treadmill intervention combined with non-immersive virtual reality, to address cognitive aspects, safe walking, and mobility, would lead to fewer falls than treadmill training alone | In a heterogeneous group of elderly people at high risk of falls, treadmill training associated with virtual reality led to lower fall rates than training with treadmill alone |
Pelosin et al., 2020 [36]
A multimodal training modulates short afferent inhibition and improves complex walking in a cohort of faller older adults with an increased prevalence of Parkinson’s disease | RCT, 4 | No: 39
(PD: 24)
VRG: 17
TG: 22
Age (elderly and PD)
VRG: 73.3
TG: 71.9 | Nonimmersive VR | VRG: treadmill training with obstacles and distractors in VR (elderly patients and with PD)
TG: treadmill training 45′ treatment, 3 times a week for 6 weeks | I.C: 2 or more falls in the previous six months; age 60–85; walk for 5 minutes without assistance; H&Y 2-3; stable therapy for at least a month
E.C: MMSE <24; psychiatric comorbidities; stroke or other neurological disease; contraindications to TMS; use of anticholinergics or acetylcholinesterase inhibitors | — | — | MoCA (elderly and PD)
VRG 23.5 (4.3)
TG: 25 (3.2)
Education received (years) (Elderly and PD)
VRG: 11.1 (4.2)
TG: 9.8 (4.7) | Primary: Number of falls SAI magnitude
Secondary: Gait parameters during normal walking (GaitRite) Overcoming obstacles | T0 (baseline)
T1 (after 1 week)
T2 (after 6 months) | Evaluate whether virtual reality-based attention training modulates cholinergic activity (SAI-short-latency afferent inhibition) and affects obstacle negotiation performance in a cohort of elderly people with a history of falls and with a higher prevalence of PD | The multitasking training carried out modulated the SAI and allowed functional improvements in gait. Furthermore, the combination of such rehabilitation approach with cholinergic pharmacological agents may optimize the recovery induced by the rehabilitation |
Pompeu et al., 2012 [37]
Effect of Nintendo Wii™-based motor and cognitive training on activities of daily living in patients with Parkinson’s disease: a randomised clinical trial | RCT, 5 | No: 32
VRG: 16
TG: 16 | Nonimmersive VR | VRG: 10 games with Wii-Fit for motor and cognitive training
TG: balance exercises without feedback or cognitive stimuli. 14 training sessions of 60′ (30′ stretching, strengthening + 30′ balance), 2 times a week for 7 weeks | I.C: age 60–85; H&Y 1–2; good visual and auditory acuity; 5–15 years of education; no other neurological or orthopaedic diseases; dementia (cut-off 23 MMSE) or depression (GDS cut-off 6)
E.C: no other experiences in using the Wii fit; not having participated in other rehabilitation programs. | — | — | MoCA
VRG: 20.6 (4.5)
TG: 21.7 (4.6) | Primary: UPDRS II (ADL)
Secondary: BBS UST MoCA | T0 (baseline)
T1 (after treatment)
T2 (after 60 days—follow up) | To study the effect of Nintendo Wii™-based cognitive-motor training compared to balance training on activities of daily living in patients with Parkinson’s disease | Patients with PD showed better performance in daily life activities after 14 balance training sessions, without any additional benefits associated with motor and cognitive training with VR |
Shih et al., 2016 [38]
Effects of balance-based exergaming intervention using the Kinect sensor on posture stability in individuals with Parkinson’s disease: a single-blinded randomized controlled trial | RCT, 6 | No: 20
VRG: 10
TG: 10
Age
VRG: 67.5
TG: 68.8
Disease duration, (years)
VRG: 27.4
TG: 28.2 | Exergaming/nonimmersive VR | VRG: balance training with exergaming (Kinect sensor)
TG: balance training 50′ sessions (30′ balance), 2 times a week for 8 weeks | I.C: H&Y 1–3; MMSE ≥ 24; stable therapy; can stand without help
E.C: history of other neurological, cardiovascular, orthopaedic disease related to postural instability; uncontrolled chronic diseases | — | VRG: 1.6
TG: 1.4 | MMSE
VRG: 27.4 (2.59)
TG: 28.2 (1.99). | Postural stability: LOS OLS balance: BBS TUG | T0 (baseline)
T1 (after 8 weeks) | Examine the effects of balance-based exergaming training using the Kinect sensor on postural stability and balance in people with Parkinson’s | Balance training with exergame resulted in a greater improvement in postural stability than conventional training. The results support the therapeutic use of exergaming with Kinect sensor in patients with PD |
Yang et al., 2016 [39]
Home-based virtual reality balance training and conventional balance training in Parkinson’s disease: a randomized controlled trial | RCT, 7 | No: 23
VRG: 11
TG: 12
Age
VRG: 72.5
TG: 75.4
Disease duration, (years)
VRG: 9.4
TG: 8.3 | Nonimmersive VR | VRG: At home. balance training with VR via Wii and balance board
TG: conventional balance training at home. 12 sessions of 50′, twice a week, for 6 weeks | I.C: age 55–85; MMSE >24; H&Y 2–3; no balance or step training in the previous 6 months; no other clinical conditions related to balance or walking
C: E: untreated depression; major visual/hearing impairments | No adverse events. 1 VRG patient dropped out as he preferred conventional training | VRG:3
TG: 3 | MMSE
VRG: 27.5 ± 4.0
TG: 27.2 ± 2.5 | Primary: BBS
Secondary: DGI TUG MPQ-39 UPDRS-III | T0 (baseline)
T1 (after 6 weeks) T2
(after 8 weeks-follow up) | Assess whether virtual reality home balance training is more effective than conventional home balance training in improving balance, walking and quality of life in patients with Parkinson’s disease | The results do not show significant differences in the improvements in balance and walking in the two treatment groups. In any case, exercises with VR at home can represent a valid alternative for patients with PD with limited access to rehabilitation services |
Yen et al., 2011 [40]
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 | RCT, 7 | No: 42
VRG: 14
TG: 14
GC: 14
Age
VRG: 70.4
TG: 70.1
GC: 71.6
Disease duration, (years)
|VRG: 6.0
TG: 6.1
GC: 7.8 | Nonimmersive VR | VRG: balance training with dynamic balance board, LCD screen with 3D games (Virtools 3.5) TG: standing balance training. GC: no treatment. 30′ sessions, twice a week for 6 weeks | I.C: MMSE >24; H&Y 2–3; not having participated in other balance and gait training; ability to follow simple commands and the absence of chronic uncontrolled diseases
E.C: history of other neurological, cardiovascular, orthopaedic diseases; on-off motor fluctuations and dyskinesia >3 on UPDRS | No adverse events, apart from the tendency to fall | VRG: 2.6
TG: 2.4
GC: 2.6 | MMSE
VRG: 28.5 (1.6)
TG: 28.5 (1.2)
GC: 28.1 (0.8) | SOT balance score | T0 (baseline)
T1 (within 7 days after 6 weeks)
T2 (after 10 weeks-follow up) | Examine the effects of balance training, associated with VR, on sensory integration of postural control and compare the results with those obtained from a conventional balance training group and an untrained control group | Both balance training with virtual reality and without could be considered valid for improving the sensory integration capacity for postural stability in people with PD |
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