Thesis (M.Sc.) - Cairo University - Faculty of Physical Therapy - Department of Musculoskeletal Disorders

Background:falling is common after a stroke which causes fractures and immobilityAim of the Study: To investigate the effect of virtual reality training with cognitive load on risk of falling in chronic stroke patients. Methodology:30 chronic stroke patientswith mild spasticity, with recurrent falling, Montreal Cognitive Assessment (MoCA) score >26 and their age ranged from 40-65 years. They were randomly assigned into two equal groups, control group (CG) and study group (SG).The patients in control group (CG) were treated with conventional physical therapy. Study group (SG) patients were treated with the same physical therapy program as in CG in addition to virtual reality (VR) balance training (using the Nintendo Wii Fit console) performed in conjunction with Dual task training. The treatment was conducted three sessions per week for four weeks. Pre and post assessment of all variables of falling were done for each patient which includedberg balance scale(BBS)and The 16-item fall efficacy scale - international (FES-I).Changes in Gaming Scoreswere recorded in the study group. Results:In study group, the mean ±SD values of pre- and post-treatment BBS were 45.80 ±3.70 and 51.70 ±2.05, respectively, with improvement percentage 12.88% butin control group were 43.90 ±4.60 and 45.10 ±4.48, respectively, with improvement percentage 2.73%. In study group, the mean ±SD values of pre- and post-treatment FES-Iwere 29.60 ±2.50 and 23.50 ±2.22 respectively but in control group were 28.50 ±1.35 and 27.59 ±1.95 respectively with improvement percentage in study group with 20.61% but in control group 3.19%.There was a significant increase in gaming scores between the 1st session and the 12th session in the study group. Improvement percentage in table tilt, tight robe and heading soccer gameswas66.32%, 68.03% and 68.85% respectively

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