An interventional study of Virtual Reality Balance System (VR-Training) and Standard Physical Therapy (Conventional Exercise) in Ankle Fractures, Joint Stiffness and Postural Balance, sponsored by Dr Aneeqa Sultan. Completed at 2 sites in Pakistan. Open to participants aged 18 Years to 60 Years. Per ClinicalTrials.gov, last updated 2026-10-30.
Sponsored by Dr Aneeqa Sultan · Not applicable, Interventional, and Treatment
This study compares virtual reality-based balance training with conventional balance therapy in adults recovering from an ankle fracture after a period of immobilization.
A total of 22 adults aged 18-60 years who were medically cleared to bear full weight on the affected leg participated in the study. Participants were randomly assigned to two groups: one received virtual reality-based balance training, and the other received conventional balance exercises.
Both groups received supervised rehabilitation sessions lasting 30 minutes, three to five times per week, for six to eight weeks. The virtual reality group performed interactive weight-shifting and balance activities with visual feedback, while the conventional therapy group performed exercises such as single-leg standing, balance board activities, BOSU ball exercises, and ankle strengthening.
Balance and ankle movement were assessed before and after the intervention. The study evaluated balance using the Berg Balance Scale, dynamic postural control using the Star Excursion Balance Test, and active ankle dorsiflexion range of motion using a goniometer. The study was designed to compare the outcomes of the two rehabilitation approaches following ankle fracture.
Background
Ankle fractures are common lower-limb injuries that may require surgical fixation or conservative management with immobilization. Following immobilization, patients may experience ankle joint stiffness, reduced muscle strength, impaired proprioception, decreased dorsiflexion range of motion, and difficulties with balance and walking. These problems can affect functional recovery and postural stability.
Conventional physical therapy commonly includes balance exercises, single-leg standing, balance board activities, and ankle strengthening. Virtual reality (VR)-based rehabilitation offers interactive exercises and visual feedback that may help patients practice controlled weight shifting and dynamic balance activities.
Study Objective
This study compared the effectiveness of virtual reality-integrated rehabilitation with conventional balance therapy in adults recovering from ankle fractures following immobilization.
Study Design and Participants
This was a single-blind randomized controlled trial involving 22 adults aged 18-60 years recruited from orthopedic rehabilitation departments in Lahore, Pakistan. Participants had medically confirmed closed malleolar ankle fractures, managed surgically or conservatively, and had been cleared for full weight-bearing ambulation. Participants were randomly allocated in a 1:1 ratio to two groups, with 11 participants in each group. Outcome assessors were blinded to group allocation.
Intervention Group: Virtual Reality-Based Balance Training
Participants received supervised rehabilitation using a virtual reality balance system. Each session lasted 30 minutes and included 15 minutes of dynamic weight-shifting exercises with visual center-of-gravity feedback, followed by 15 minutes of interactive balance tasks involving target matching, obstacle avoidance, and multidirectional postural adjustments. Exercise difficulty was adjusted according to participant performance.
Comparison Group: Conventional Balance Therapy
Participants received a supervised conventional balance therapy program lasting 30 minutes per session. Exercises included static single-leg standing, tandem standing, wobble board balancing, BOSU ball stability exercises, and ankle strengthening with resistance bands. Exercise difficulty was progressed by the therapist according to clinical tolerance.
Both groups received treatment three to five days per week for six to eight weeks, with approximately 20-24 sessions.
Outcome Measures
Outcomes were assessed at baseline and immediately after the intervention.
Statistical Analysis
Within-group changes were assessed using the Wilcoxon signed-rank test, while between-group comparisons were performed using the Mann-Whitney U test.
Study Purpose
The study was designed to compare changes in balance, dynamic postural control, and ankle dorsiflexion range of motion following virtual reality-based rehabilitation and conventional balance therapy in adults recovering from ankle fractures.
202 studies on the registry are indexed under Ankle Fractures; 44 are open to participants now.
This study's enrollment of 22 is below the median of 90 across 150 interventional studies indexed under Ankle Fractures.
Browse Ankle Fractures studies →Dr Aneeqa Sultan is the lead sponsor of 3 studies on the registry; none are open to participants now.
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Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Participants complete interactive virtual reality-integrated balance training using the VR-Balance System. Sessions last 30 minutes, 3 to 5 days per week for 6 to 8 weeks (total 20-24 sessions). The program includes 15 minutes of guided center-of-gravity weight shifting with visual feedback and 15 minutes of gamified multidirectional dynamic balance tasks.
Behavioral: Virtual Reality Balance System (VR-Training)
Participants receive a standardized conventional balance physical therapy program. Sessions last 30 minutes, 3 to 5 days per week for 6 to 8 weeks (total 20-24 sessions). Exercises consist of static single-leg stance, wobble board balancing, BOSU ball stability exercises, and TheraBand lower-limb strengthening.
Behavioral: Standard Physical Therapy (Conventional Exercise)
Supervised digital feedback training program. Participants stand on an integrated sensor platform facing an interactive screen displaying center-of-mass displacement. Exercises involve target matching, obstacle dodging, and controlled postural weight shifts. Adaptive difficulty scales with user performance to enhance motor recalibration.
Supervised manual balance therapy. Interventions include single-leg stance drills, tandem standing, balance board tilting, BOSU ball balancing, and manual resistance ankle exercises. Difficulty is manually progressed by the physical therapist based on clinical tolerance.
Change in Static Balance Measured by the Berg Balance Scale (BBS)
The Berg Balance Scale assesses balance and functional performance across 14 standardized tasks. Total scores range from 0 to 56, with higher scores indicating better balance control. Change from baseline to post-intervention will be evaluated.
Time frame: Baseline and immediately after the 6-to-8-week intervention
Change in Dynamic Postural Control Measured by the Star Excursion Balance Test (SEBT)
The Star Excursion Balance Test assesses dynamic balance using posteromedial reach and the overall composite score. Reach distance is normalized to leg length and expressed as a percentage. Higher percentages indicate better dynamic stability. Change from baseline to post-intervention will be evaluated.
Time frame: Baseline and immediately after the 6-to-8-week intervention
Change in Active Ankle Dorsiflexion Range of Motion
Active weight-bearing ankle dorsiflexion range of motion is measured in degrees using a universal goniometer. An increase in degrees indicates improved ankle dorsiflexion. Change from baseline to post-intervention will be evaluated.
Time frame: Baseline and immediately after the 6-to-8-week intervention
Plan to share: No
No publications or documents are linked to this record.
Ran from Apr 2026 to primary completion in Aug 2026, 4 months.
Of 69 non-industry interventional studies with no phase under Ankle Fractures, half reached primary completion within 44 months of starting (the median), counting those still running; a quarter within 23 and three quarters within 61. This study's 4 months is below that.
Counting every sponsor, half of 72 studies reached it within 45 months; a quarter within 23 and three quarters within 61.
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
This study is completed, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.
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Dr Aneeqa Sultan