NIH Stage 1/2 Study: Investigating the Feasibility, Usability, and Benefits of Fully Immersive VR Overground Gait Rehabilitation for Stroke Survivors

About This Grant

PROJECT SUMMARY Stroke has a profound impact on mobility, significantly affecting survivors' independence and quality of life (QoL). Developing more effective therapeutic interventions that accelerate gait recovery and enhance functional independence is essential. Research suggests that the most effective way for stroke survivors to maximize their gait recovery is to practice walking in the environments they aspire to navigate. However, real-world gait training is often limited by safety concerns, environmental constraints, and accessibility barriers. Virtual reality (VR) presents a promising alternative, allowing stroke survivors to practice walking in immersive, simulated environments that replicate real-world settings. These VR environments enable gait training that closely mimics real-life walking conditions while providing a controlled and safe setting. Despite this potential, current gait rehabilitation practices have yet to fully implement the promise of VR, as existing approaches, such as VR- assisted treadmill training (e.g., C-Mill training), may not fully replicate the demands of real-world walking environments. The essential goal of our research is to validate a fully immersive VR-assisted overground gait training program that maximizes gait recovery, improves real-world mobility, promotes independence, and enhances overall QoL for stroke survivors. To achieve this, through an iterative participatory design study with physical therapists (PTs) and stroke survivors, we developed a fully immersive VR solution that simulates three diverse real-world environments—City, Beach, and Airport—allowing stroke survivors to engage in realistic overground walking exercises. In this proposed project, we will conduct a pilot clinical trial with three specific aims: (1) Investigate the feasibility and usability of fully immersive VR-assisted overground gait training for stroke survivors, (2) Evaluate the effectiveness of fully immersive VR-assisted overground gait training compared to non-immersive VR-assisted treadmill gait training (C-Mill training), the current clinical best practice, and (3) Refine our VR solution to prepare for future large-scale randomized clinical trials aimed at broad clinical implementation. Our central hypothesis is that fully immersive VR-assisted overground gait training will provide greater therapeutic benefits in daily physical mobility and QoL than conventional non-immersive VR- assisted treadmill training. This study will serve as a critical first step toward a large-scale, multi-site NIH-funded clinical trial designed to establish definitive evidence of the therapeutic impact of VR-assisted overground gait training. The findings will advance gait rehabilitation practices and have broader implications for other patient populations with chronic mobility deficits requiring gait training.