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Home-Based Virtual Reality Treatment for Chronic Balance Problems in Adults with TBI

PI(s): Jeff Cuthbert, PhD, MPH, MS; Denise O'Dell, DScPT; and Candy Tefertiller, DPT
Funded by: National Institute on Disability and Rehabilitation Research
Dates: 2012-2017
Contact: Jeff Cuthbert jcuthbert@craighospital.org 303 789 8028

The purpose of this study is to evaluate the efficacy of a home-based PT program which aims to enhance balance following TBI by incorporating the use of a VR system. Balance deficits have been shown to persist long-term in people with TBI and subsequently limit community participation and decrease quality of life. There is limited evidence for the treatment of diminished balance for people with TBI, particularly for those with chronic deficits; however, research in populations with neurological deficits similar to TBI has demonstrated that VR can be an effective modality in improving balance. To assess the efficacy of VR treatments in improving balance and mobility skills for people with chronic balance deficits associated with TBI, an individually tailored, structured, reproducible 12-week intervention has been developed. The evidence-based strategies of motor learning designed to facilitate functional recovery that comprise this intervention include the provision of new and challenging movements, repetitive-procedural practice, visual feedback, and use of a structured progressive exercise program. The goals of the intervention are to increase balance and mobility, enhance overall balance system function, reduce fear of falling, improve treatment adherence, and improve participation in life activities for individuals with TBI who have already completed direct PT opportunities.

Extension Study

Funded by: Craig Hospital Foundation
Dates: 2012-2017

The purpose of this study is to extend the current VR research project (above) to include objective measures of balance control and postural stability using the SMART Equitest balance system. Four core tests from this system will be utilized for computerized measures of balance. These tests are used to qualify and quantify balance and postural deficits, to assess the underlying sensory and motor systems associated with these deficits, and to identify any maladaptive patterns of balance control. The data from the SMART Equitest core tests will be collected with the intent of examining the validity of the primary outcome measures of the VR study.