The Effect of a Fully Immersive Virtual Reality Training Program on Walking Parameters in People With Unilateral Below‐Knee Amputation: An Experimental and a Single‐Subject Study

ABSTRACT Background and Aims The virtual reality (VR) environment has the potential to be an effective component of walking training in the rehabilitation of lower limb amputees. Creating an accessible walking training program based on fully immersive VR environment could enhance the applicability of this technology in this population. Methods This is a single‐subject ABA design study consisted of two parts. The first part focused on developing a VR video and evaluating its immersion and user experience among ten individuals with transtibial amputations. The second part was an ABA‐style single‐subject study involving two participants with a new traumatic transtibial amputation. These participants used the developed VR environment for 6 weeks. Outcome measures were including the 10‐m walk test, spatiotemporal gait parameters, and presence, before the VR training and after the 6 weeks training. All measurements were repeated every other day during four experimental sessions in baseline, immediately after intervention and 4 weeks after end of intervention to ensure the stability of reported variables frequency. Results The quality of the fully immersive VR video was evaluated by ten amputee participants. The mean scores for presence, entertainment, and immersion exceeded half of the maximum score, while the comfort score did not reach half. After 6 weeks of intervention, the 10‐m walk test showed speed improvement by a mean increase of 0.3 m/s. The duration of the stance and loading response phases increased in both limbs. Step and stride lengths exhibited an increase corresponding to the enhanced velocity of walking. The immersion score exhibited a one and half point increase before and after the 6 weeks of intervention. Conclusion A fully immersive virtual reality video‐based walking training program is well‐accepted by transtibial prosthetic users and demonstrates potential to impact gait parameters and improve walking asymmetry in individuals with transtibial amputation.