Virtual Reality-Based Wii Fit Training in Improving Muscle Strength, Sensory Integration Ability, and Walking Abilities in Patients with Parkinson's Disease: A Randomized Control Trial

Background: Virtual reality (VR) systems have been proven to increase motor performance in stroke and elderly patients. However, the effects have not been established in patients with Parkinson's disease (PD). The aim of this study was to examine the effects of VR-based training in improving muscle strength, sensory integration ability, and walking abilities in patients with PD through a randomized controlled trial. Methods: Thirty-six individuals who have been diagnosed with PD were randomly assigned to one of three groups (n = 12 for each group). Participants performed VR-based Wii Fit exercise (VRWii group) or traditional exercise (TE group) for 45 minutes, followed by treadmill training for another 15 minutes for 12 sessions in 6 weeks. Participants in the control group did not undergo the structured exercise program, but received fall-prevention education instead. The study outcomes included lower extremity muscle strength, sensory integration ability, walking velocity, stride length, and functional gait assessment. All outcomes were assessed at baseline, after training, and at 1 month follow-up. Results: Both the VRWii and TE groups showed more improvement in level walking velocity, stride length, functional gait assessment, muscle strength, and vestibular system integration compared with the control group after training and at 1 month follow-up. The VRWii training, but not the TE training, resulted in greater improvement in visual system integration than the control. Conclusion: VRWii training is as beneficial as TE in improving walking abilities, sensory integration ability, and muscle strength in patients with PD, and such improvements persisted for at least for 1 month. VRWii training is thus suggested to be implemented in patients with PD