Effects of the home-based exercise program with an augmented reality system on balance in patients with stroke: a randomized controlled trial

Purpose: To investigate the therapeutic potentials of the home-based exercise program (HEP) with an augmented reality (AR) system to improve balance in patients with stroke. Methods: Sixty-eight patients with stroke were recruited in this randomized controlled study with blind observer. Patients in the smart-rehab group underwent HEP with an AR system for four weeks, whereas patients in the control group underwent the written and pictorial HEP. Assessments of balance and fear of falling were performed three times: at baseline (T0), immediately (T1), and four weeks (T2) after cessation of HEP. Results: The change in balance from T0 to T1 was significantly higher in the smart-rehab group than in the control group (p < 0.017). The change in fear of falling from T0 to T1 and T2 was significantly higher in the smart-rehab group than in the control group, respectively (p < 0.017). One participant with vertebral artery dissection in the smart-rehab group discontinued participation due to a transient ischemic attack which resolved during the study period. Conclusions: The results of this study suggest that the HEP with the AR system might be effective to improve balance in patients with stroke. However, more careful precautions for the HEP using the AR system are also required. Implications for rehabilitation Balance was modestly improved in both home-based exercise programs, slightly more in AR home exercise group. AR home-based program was significantly better in reducing fear of falling compared to the control group. No falls were recorded, however, safety for patients with arterial dissection needs to be carefully considered due to the possibility of adverse effects.