CClinicalTrials.gg
RecruitingNCT06780488Updated Jan 23, 2026

Visuo-Vestibular VR-based Stimulation Effects on Balance and Gait in Stroke Survivors

An interventional study of Real Visual-Vestibuar Rehabilitation and Sham Rehabilitation in Stroke, sponsored by I.R.C.C.S. Fondazione Santa Lucia. Recruiting at 1 site in Italy. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2026-01-23.

Sponsored by I.R.C.C.S. Fondazione Santa Lucia · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
38
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

This pilot study aims to evaluate the effect of a specfic Virtual-Reality-Based rehabilitation training in patients with stroke. A total of 38 patients with stroke (more than 6 months from the acute event), recruited from the services of the Fondazione Santa Lucia IRCCS in Rome, will be included in the present study. Participants will be randomized into two groups: a Real group and a Sham group. Both groups will undergo a rehabilitation intervention using an immersive virtual reality system. The Real group will be exposed to scenarios containing specific stimuli for the visuo-vestibular system, while the Sham group will be exposed to the same scenarios but without specific stimuli. All participants in both groups will undergo 12 treatment sessions (three times a week), each lasting 20 minutes. All treatments will be conducted by physiotherapists specialized in neurological and vestibular rehabilitation. Patients will be assessed before the start of the treatment, at the end of the intervention, and one month after its completion, in order to evaluate the effects of the experimental training on balance and gait, and on the patient's perceived quality of life. Another aim will be to assess the user's satisfaction with the new proposed protocol.

02

Conditions studied

  • Stroke

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Keywords

  • Stroke
  • Vestibular Rehabilitation
  • Virtual Reality
  • Balance
  • Gait
  • Quality of Life
03

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Subjects with a history of hemorrhagic or ischemic stroke (more than 6 months from the acute event)
  • Patients aged between 18 and 80 years
  • Absence of cognitive deficits that may interfere with the patient's ability to understand the exercise instructions (MiniMentalState Evaluation > 24)
  • Functional Ambulation Category ≥ 3
  • Absence of associated orthopedic, visual, and/or neurological issues (clinically assessed) that may affect participation in the study

Exclusion criteria

Exclusion Criteria:

  • Patients with stroke (less than 6 months from the acute event);
  • Patients aged under 18 and over 80;
  • Presence of associated orthopedic, visual, and/or neurological issues (clinically assessed) that may affect participation in the study;
  • Presence of cognitive deficits that may interfere with the patient's ability to understand the exercise instructions (MiniMentalState Evaluation ≤ 24);
  • Epilepsy.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
38 participants (estimated)

Study arms

  • Experimental
    Real

    Other: Real Visual-Vestibuar Rehabilitation

  • Sham comparator
    Control

    Other: Sham Rehabilitation

Interventions

  • OtherReal Visual-Vestibuar Rehabilitation

    The "Real Visual-Vestibular Rehabilitation" protocol will consist of specific exercises aimed at stimulating the visuo-vestibular function within immersive virtual reality environments replicating daily life situations. Patients will perform exercises in two types of contexts. In all exercises, patients will be free to move within a room large enough to complete the tasks. Walking during the exercises can also be performed with assistive devices, to make the context as close as possible to the patient's daily life. During the exercises, patients will be supervised by a physiotherapist specialized in neurological and vestibular rehabilitation.The protocol will last 20 minutes, with 10 minutes dedicated to each exercise.

  • OtherSham Rehabilitation

    The "Sham Vestibular Rehabilitation" protocol will involve the use of the same immersive virtual reality contexts and will aim to achieve the same objectives as the Real Visual-Vestibular Rehabilitation protocol, but without the "unexpected" stimuli. In both exercises, patients will be free to move within a room large enough to complete the tasks. Walking during the session can also be performed with assistive devices, to make the context as close as possible to the patient's daily life. During the exercises, patients will be supervised by a physiotherapist specialized in neurological and vestibular rehabilitation. The protocol will last 20 minutes, with 10 minutes dedicated to each exercise.

05

What researchers measure

Primary outcomes

  1. Mini-BESTest

    The Mini-BESTest is a clinical scale used to assess balance and fall risk, consisting of 14 items covering anticipatory, reactive, dynamic balance, and transfers. Scoring: ranges from 0 (worst balance) to 28 (best balance); higher scores indicate better performance, while lower scores indicate greater fall risk or postural deficits.

    Time frame: T0 (Baseline)

  2. Mini-BESTest

    The Mini-BESTest is a clinical scale used to assess balance and fall risk, consisting of 14 items covering anticipatory, reactive, dynamic balance, and transfers. Scoring: ranges from 0 (worst balance) to 28 (best balance); higher scores indicate better performance, while lower scores indicate greater fall risk or postural deficits.

    Time frame: T1 (4 weeks from the baseline - end of treatment period)

  3. Mini-BESTest

    The Mini-BESTest is a clinical scale used to assess balance and fall risk, consisting of 14 items covering anticipatory, reactive, dynamic balance, and transfers. Scoring: ranges from 0 (worst balance) to 28 (best balance); higher scores indicate better performance, while lower scores indicate greater fall risk or postural deficits.

    Time frame: T2 ( 4 weeks and 1 month from the baseline - 1 month follow up)

Secondary outcomes

  1. Berg Balance Scale

    The Berg Balance Scale (BBS) is a clinical tool used to assess static and dynamic balance through 14 functional tasks, such as standing, reaching, and turning. Scoring: ranges from 0 (poor balance) to 56 (excellent balance); higher scores indicate better balance, while lower scores suggest increased risk of falls.

    Time frame: T0 (Baseline)

  2. Berg Balance Scale

    The Berg Balance Scale (BBS) is a clinical tool used to assess static and dynamic balance through 14 functional tasks, such as standing, reaching, and turning. Scoring: ranges from 0 (poor balance) to 56 (excellent balance); higher scores indicate better balance, while lower scores suggest increased risk of falls.

    Time frame: T1 (4 weeks from the baseline - end of treatment period)

  3. Berg Balance Scale

    The Berg Balance Scale (BBS) is a clinical tool used to assess static and dynamic balance through 14 functional tasks, such as standing, reaching, and turning. Scoring: ranges from 0 (poor balance) to 56 (excellent balance); higher scores indicate better balance, while lower scores suggest increased risk of falls.

    Time frame: T2 ( 4 weeks and 1 month from the baseline - 1 month follow up)

  4. Performance Oriented Mobility Assessment

    The Performance Oriented Mobility Assessment (POMA), also called the Tinetti Test, evaluates gait and balance to estimate fall risk in older adults. It includes two sections: balance (sitting, standing, turning) and gait (initiation, step length, symmetry). Scoring: total ranges from 0 (highest fall risk / worst performance) to 28 (lowest fall risk / best performance); higher scores indicate better mobility and lower fall risk.

    Time frame: T0 (Baseline)

  5. Performance Oriented Mobility Assessment

    The Performance Oriented Mobility Assessment (POMA), also called the Tinetti Test, evaluates gait and balance to estimate fall risk in older adults. It includes two sections: balance (sitting, standing, turning) and gait (initiation, step length, symmetry). Scoring: total ranges from 0 (highest fall risk / worst performance) to 28 (lowest fall risk / best performance); higher scores indicate better mobility and lower fall risk.

    Time frame: T1 (4 weeks from the baseline - end of treatment period)

  6. Performance Oriented Mobility Assessment

    The Performance Oriented Mobility Assessment (POMA), also called the Tinetti Test, evaluates gait and balance to estimate fall risk in older adults. It includes two sections: balance (sitting, standing, turning) and gait (initiation, step length, symmetry). Scoring: total ranges from 0 (highest fall risk / worst performance) to 28 (lowest fall risk / best performance); higher scores indicate better mobility and lower fall risk.

    Time frame: T2 ( 4 weeks and 1 month from the baseline - 1 month follow up)

  7. Modified Barthel Index

    The Modified Barthel Index (MBI) is a scale that measures a person's independence in activities of daily living (ADLs), such as feeding, bathing, dressing, and mobility. Scoring: ranges from 0 (completely dependent) to 100 (completely independent); higher scores indicate greater independence, lower scores indicate more severe dependency.

    Time frame: T0 (Baseline)

  8. Modified Barthel Index

    The Modified Barthel Index (MBI) is a scale that measures a person's independence in activities of daily living (ADLs), such as feeding, bathing, dressing, and mobility. Scoring: ranges from 0 (completely dependent) to 100 (completely independent); higher scores indicate greater independence, lower scores indicate more severe dependency.

    Time frame: T1 (4 weeks from the baseline - end of treatment period)

  9. Modified Barthel Index

    The Modified Barthel Index (MBI) is a scale that measures a person's independence in activities of daily living (ADLs), such as feeding, bathing, dressing, and mobility. Scoring: ranges from 0 (completely dependent) to 100 (completely independent); higher scores indicate greater independence, lower scores indicate more severe dependency.

    Time frame: T2 ( 4 weeks and 1 month from the baseline - 1 month follow up)

  10. Stroke Specific Quality of Life Scale

    The Stroke Specific Quality of Life Scale (SS-QOL) is a questionnaire designed to assess health-related quality of life in stroke survivors, covering physical, emotional, cognitive, and social domains. Scoring: total scores typically range from 49 (worst quality of life) to 245 (best quality of life), with higher scores reflecting better perceived well-being and function.

    Time frame: T0 (Baseline)

  11. Stroke Specific Quality of Life Scale

    The Stroke Specific Quality of Life Scale (SS-QOL) is a questionnaire designed to assess health-related quality of life in stroke survivors, covering physical, emotional, cognitive, and social domains. Scoring: total scores typically range from 49 (worst quality of life) to 245 (best quality of life), with higher scores reflecting better perceived well-being and function.

    Time frame: T1 (4 weeks from the baseline - end of treatment period)

  12. Stroke Specific Quality of Life Scale

    The Stroke Specific Quality of Life Scale (SS-QOL) is a questionnaire designed to assess health-related quality of life in stroke survivors, covering physical, emotional, cognitive, and social domains. Scoring: total scores typically range from 49 (worst quality of life) to 245 (best quality of life), with higher scores reflecting better perceived well-being and function.

    Time frame: T2 ( 4 weeks and 1 month from the baseline - 1 month follow up)

  13. User Satisfaction Evaluation Questionnaire

    The User Satisfaction Evaluation Questionnaire (USEQ) is a tool used to measure users' satisfaction with a device, system, or service, focusing on usability, comfort, and overall experience. Scoring: typically ranges from 6 (lowest satisfaction) to 30 (highest satisfaction); higher scores indicate greater user satisfaction, while lower scores suggest issues or dissatisfaction.

    Time frame: T0 (Baseline)

  14. User Satisfaction Evaluation Questionnaire

    The User Satisfaction Evaluation Questionnaire (USEQ) is a tool used to measure users' satisfaction with a device, system, or service, focusing on usability, comfort, and overall experience. Scoring: typically ranges from 6 (lowest satisfaction) to 30 (highest satisfaction); higher scores indicate greater user satisfaction, while lower scores suggest issues or dissatisfaction.

    Time frame: T1 (4 weeks from the baseline - end of treatment period)

  15. User Satisfaction Evaluation Questionnaire

    The User Satisfaction Evaluation Questionnaire (USEQ) is a tool used to measure users' satisfaction with a device, system, or service, focusing on usability, comfort, and overall experience. Scoring: typically ranges from 6 (lowest satisfaction) to 30 (highest satisfaction); higher scores indicate greater user satisfaction, while lower scores suggest issues or dissatisfaction.

    Time frame: T2 ( 4 weeks and 1 month from the baseline - 1 month follow up)

  16. Instrumental Gait Evaluation

    The instrumental motor assessment will be performed using seven wearable inertial sensors (128 Hz, Opal, APDM, Portland, Oregon, USA), which operate with an internal battery and are completely wireless. Each inertial sensor contains a triaxial accelerometer, capable of measuring accelerations along its three axes, which will align with the body axes (antero-posterior, lateral-lateral, cranio-caudal), and a triaxial gyroscope to measure angular velocities around these same axes. The seven wearable sensors will be placed using elastic supports at the level of the lambdoid suture of the skull, trunk, sacrum (L4-L5), tibias, and wrists. Accelerations and angular velocities of the body segments of interest will be measured, and from these, various parameters will be extrapolated both in the time and frequency domains. The motor assessment using inertial sensors will be conducted during the execution of four motor tasks: The 10 Meter Walk Test, The Fukuda Stepping Test, The Figure-of-8 Walk

    Time frame: T0 (Baseline)

  17. Instrumental Gait Evaluation

    The instrumental motor assessment will be performed using seven wearable inertial sensors (128 Hz, Opal, APDM, Portland, Oregon, USA), which operate with an internal battery and are completely wireless. Each inertial sensor contains a triaxial accelerometer, capable of measuring accelerations along its three axes, which will align with the body axes (antero-posterior, lateral-lateral, cranio-caudal), and a triaxial gyroscope to measure angular velocities around these same axes. The seven wearable sensors will be placed using elastic supports at the level of the lambdoid suture of the skull, trunk, sacrum (L4-L5), tibias, and wrists. Accelerations and angular velocities of the body segments of interest will be measured, and from these, various parameters will be extrapolated both in the time and frequency domains. The motor assessment using inertial sensors will be conducted during the execution of four motor tasks: The 10 Meter Walk Test, The Fukuda Stepping Test, The Figure-of-8 Walk

    Time frame: T1 (4 weeks from the baseline - end of treatment period)

  18. Instrumental Gait Evaluation

    The instrumental motor assessment will be performed using seven wearable inertial sensors (128 Hz, Opal, APDM, Portland, Oregon, USA), which operate with an internal battery and are completely wireless. Each inertial sensor contains a triaxial accelerometer, capable of measuring accelerations along its three axes, which will align with the body axes (antero-posterior, lateral-lateral, cranio-caudal), and a triaxial gyroscope to measure angular velocities around these same axes. The seven wearable sensors will be placed using elastic supports at the level of the lambdoid suture of the skull, trunk, sacrum (L4-L5), tibias, and wrists. Accelerations and angular velocities of the body segments of interest will be measured, and from these, various parameters will be extrapolated both in the time and frequency domains. The motor assessment using inertial sensors will be conducted during the execution of four motor tasks: The 10 Meter Walk Test, The Fukuda Stepping Test, The Figure-of-8 Walk

    Time frame: T2 ( 4 weeks and 1 month from the baseline - 1 month follow up)

  19. Instrumental assessment of vestibular function

    The assessment of vestibular function will be performed using the Video Head Impulse Test, vHIT OtosuiteV®, GN Otometrics, Denmark. Data related to the gain of the vestibulo-ocular reflex (VOR) during the Head Impulse Paradigm (HIMP) and the Suppression Head Impulse Paradigm (SHIMP) will be considered.

    Time frame: T0 (Baseline)

  20. Instrumental assessment of vestibular function

    The assessment of vestibular function will be performed using the Video Head Impulse Test, vHIT OtosuiteV®, GN Otometrics, Denmark. Data related to the gain of the vestibulo-ocular reflex (VOR) during the Head Impulse Paradigm (HIMP) and the Suppression Head Impulse Paradigm (SHIMP) will be considered.

    Time frame: T1 (4 weeks from the baseline - end of treatment period)

  21. Instrumental assessment of vestibular function

    The assessment of vestibular function will be performed using the Video Head Impulse Test, vHIT OtosuiteV®, GN Otometrics, Denmark. Data related to the gain of the vestibulo-ocular reflex (VOR) during the Head Impulse Paradigm (HIMP) and the Suppression Head Impulse Paradigm (SHIMP) will be considered.

    Time frame: T2 ( 4 weeks and 1 month from the baseline - 1 month follow up)

06

Study locations

1 of 1 sites recruiting
  • Fondazione Santa Lucia IRCCS
    Roma, RM 00142, Italy
    Recruiting
07

References and documents

Publications

  • LeMarshall SJ, Stevens LM, Ragg NP, Barnes L, Foster J, Canetti EFD. Virtual reality-based interventions for the rehabilitation of vestibular and balance impairments post-concussion: a scoping review. J Neuroeng Rehabil. 2023 Mar 3;20(1):31. doi: 10.1186/s12984-023-01145-4. PubMed 36869367 ↗
  • Mao Y, Chen P, Li L, Huang D. Virtual reality training improves balance function. Neural Regen Res. 2014 Sep 1;9(17):1628-34. doi: 10.4103/1673-5374.141795. PubMed 25368651 ↗
  • Martino Cinnera A, Verna V, Marucci M, Tavernese A, Magnotti L, Matano A, D'Acunto C, Paolucci S, Morone G, Betti V, Tramontano M. Immersive Virtual Reality for Treatment of Unilateral Spatial Neglect via Eye-Tracking Biofeedback: RCT Protocol and Usability Testing. Brain Sci. 2024 Mar 15;14(3):283. doi: 10.3390/brainsci14030283. PubMed 38539671 ↗
  • Tramontano M, Russo V, Spitoni GF, Ciancarelli I, Paolucci S, Manzari L, Morone G. Efficacy of Vestibular Rehabilitation in Patients With Neurologic Disorders: A Systematic Review. Arch Phys Med Rehabil. 2021 Jul;102(7):1379-1389. doi: 10.1016/j.apmr.2020.11.017. Epub 2020 Dec 28. PubMed 33383031 ↗
08

Registry details

Key details

Study ID
NCT06780488
Lead sponsor
I.R.C.C.S. Fondazione Santa Lucia
Responsible party
Sponsor
First posted
Jan 17, 2025
Start date
Jan 1, 2025
Primary completion
Dec 2026 (estimated)
Completion
Sep 2027 (estimated)
Last update
Jan 23, 2026

Study contacts

Sara De Angelis, MSc
Contact
s.deangelis@hasantalucia.it
00390651501772
Jacopo Piermaria
principal investigator · Fondazione Santa Lucia IRCCS
Diego Piatti, PT
study chair · Fondazione Santa Lucia IRCCS
Sara De Angelis, MSc
study chair · Fondazione Santa Lucia IRCCS
Roberta Annicchiarico, MD
study chair · Fondazione Santa Lucia IRCCS
Matteo Marucci, PhD
study chair · Department of Psychology, Sapienza University of Rome, Rome, Italy; Laboratory of Neuroscience and Applied Technology, Santa Lucia Foundation IRCCS, Rome, Italy.
Viviana Betti, Prof.
study chair · Department of Psychology, Sapienza University of Rome, Rome, Italy; Laboratory of Neuroscience and Applied Technology, Santa Lucia Foundation IRCCS, Rome, Italy.
Marco Tramontano, Prof
study director · Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy.; Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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