The effect of sensory reintegration training with virtual reality and vibratory noise on gait in patients with diabetic peripheral neuropathy




McCrory, Bethany
Bugnariu, Nicoleta


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Purpose: The purpose of this study was to assess the effectiveness of a training program designed to improve gait function and decrease fall risk through sensory reweighting based on the principles of stochastic resonance and using virtual reality (VR) in subjects with diabetic peripheral neuropathy. Methods: This study was conducted using a V-Gait CAREN system. Subjects had 6, one hour long training sessions in which they walked on the treadmill at self-selected speed while practicing increasingly more challenging mobility tasks while their visual attention was engaged by the VR. During training, subjects were fitted with vibratory devices placed above the level of sensory loss (around the ankles) delivering constant sub-threshold white noise. At visits 1 and 8, assessments of gait function and fall risk were conducted using self-selected gait speed, Timed Up and Go (TUG) and Dynamic Gait Index (DGI). Data was analyzed with paired t-tests. Results: Comparisons of pre- and post-training data revealed a significant change in TUG (p=0.02) and a significant change in DGI (p=0.02). At the end of the training subjects were able to maintain a straight walking trajectory even in the presence of visual inputs entraining lateral movements. Conclusions: Preliminary results suggest support for the stochastic resonance theory and show that sensory retraining with VR and the vibratory device is feasible in diabetic subjects, holding promise for improvement of function due to an increased ability to integrate all sensory inputs available and a decreased reliance on visual inputs.