EFFECTIVENESS OF DUAL-TASK VIRTUAL REALITY TRAINING ON BALANCE, GAIT PERFORMANCE, AND COGNITIVE FUNCTION IN INDIVIDUALS WITH STROKE: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Stroke frequently results in persistent impairments in balance, gait, and cognitive function, limiting functional independence and quality of life. Although virtual reality (VR) has emerged as a promising rehabilitation approach, evidence regarding the effectiveness of dual-task VR training integrating simultaneous motor and cognitive activities remains limited. Objective: To evaluate the effectiveness of dual-task virtual reality training combined with conventional physiotherapy on balance, gait performance, and cognitive function in individuals with stroke. Methods: A single-center randomized controlled trial was conducted involving 46 individuals with stroke who met the eligibility criteria. Participants were randomly allocated to either the experimental group (dual-task VR training plus conventional physiotherapy; n = 23) or the control group (conventional physiotherapy alone; n = 23). Both groups received supervised rehabilitation for 8 weeks. Balance was assessed using the Berg Balance Scale (BBS), functional mobility using the Timed Up and Go (TUG) test, gait performance using the 10-Meter Walk Test (10MWT), and cognitive function using the Montreal Cognitive Assessment (MoCA). Data was analyzed using paired and independent t-tests, while between-group differences were evaluated using analysis of covariance (ANCOVA). Statistical significance was set at p < 0.05. Results: Both groups demonstrated significant improvements following the intervention; however, participants receiving dual-task VR training achieved significantly greater improvements in BBS, TUG, 10MWT, and MoCA scores compared with the conventional physiotherapy group (all p < 0.001). ANCOVA confirmed significant between-group treatment effects across all primary outcome measures after adjusting for baseline values. Conclusion: Dual-task virtual reality training combined with conventional physiotherapy was more effective than conventional physiotherapy alone in improving balance, gait performance, functional mobility, and cognitive function in individuals with stroke. Incorporating cognitive and motor tasks within an interactive virtual environment may represent an effective strategy for enhancing post-stroke rehabilitation. Larger multicenter randomized controlled trials with longer follow-up are recommended to confirm these findings.