Current literature looks on safe gait as a complex task, depending on motor and cognitive resources. The use of virtual reality (VR) in gait training offers a multifactorial approach, showing positive effects on mobility, balance, and fall risk in elderly people and individuals with neurological disorders. This form of training has been described as a viable research tool; however, it has not been applied routinely in clinical practice. Recently, VR was used to develop an adjunct training method for use by physical therapists in an ambulatory clinical setting. The aim of this article is to describe the initial clinical experience of administering a 5-week VR clinical service to improve gait and mobility in people with a history of falls, poor mobility, or postural instability. The clinical records of the first 60 patients who completed the VR gait training program were examined. Training was provided 3 times per week for 5 weeks, with each session lasting approximately 1 hour and consisting of walking on a treadmill while negotiating virtual obstacles. Comparisons were made of main outcome measures across time and included the Timed “Up & Go” Test (TUG), the Two-Minute Walk Test (2MWT), and the Four Square Step Test (FSST). After 5 weeks of training, time to complete the TUG decreased by 10.3%, the distance walked during the 2MWT increased by 9.5%, and performance on the FSST improved by 13%.
Treadmill training with VR seems to be an effective and practical tool that can be applied in an outpatient physical therapy clinic. This training seems to result in improvements in gait, mobility, and postural control. It, perhaps, also may augment cognitive and functional aspects.