Table 2.
Summary of the interventions, outcomes, and the main results.
| Author(s) | Intervention group 1 | Intervention group 2 | Control group | Dosage | Outcome measures | Results |
|---|---|---|---|---|---|---|
| Kim and Heo 31 | Strengthening and balance VR programs | Strengthening and balance exercises | – | 20 min/d, 3 d/wk. for 4 wks. | Balance using Biodex Balance System | Static balance and dynamic balance were significantly lower in the overall direction than conventional exercise. |
| Punt et al 33 | Wii Fit™ balance games | Conventional rehabilitation | NO exercise at all | E1 (30 min/d, 2 d/wk. for 6 wks), E2 (30 min/day, 9 d for 6 wk.) | • Gait speed • Cadence • Step length • Single-support time • Symmetry index of the step length • Symmetry of the single-support time • Maximum dorsiflexion and maximum plantar flexion |
Gait speed, cadence and step length improved significantly in the three groups. The single support time and symmetry index of step length improved significantly in the Wii Fit™ group. |
| Kim et al 26 | Strengthening and balance VR programs | Strengthening and balance exercises | – | 20 min/d, 3 d/wk. for 4 wks. | Ankle muscle strength using Biodex isokinetic dynamometer | VR group showed significant improvement only for PF, while the TRI group showed significant improvements in the 4 ankle motions. No significant differences were found between the 2 groups. |
| Kim and Jun 28 | VR strengthening exercises | VR balance programs | 20 min | Ankle muscle strength using Biodex isokinetic dynamometer | For strengthening group, only PF and DF showed statistically significant improvement. In the balance group, the 4 ankle motions showed statistically significant improvement. | |
| Punt et al 35 | Wii Fit™ balance games | Conventional rehabilitation | NO exercise at all | E1 (30 min/d, 2 d/wk. for 6 weeks), E2 (30 min/day, 9 d for 6 wk.) | • Self-reported physical function using FAAM • Pain at rest and while walking using VAS |
FAA showed significant improvement in all groups. VAS scores during rest and walking showed significant improvement in the Wii Fit™ group. No significant differences were detected regarding VAS scores among the 3 groups. |
| Nam et al 32 | Visual feedback balance training and ankle joint exercises | stretching and muscle-strengthening exercises | – | 30 min/d, 3 d/wk. for 8 wks. | • Balance using Biorescue to measure LOS • Ankle instability using CAIT |
LOS measurements showed significant improvement in the experimental group. Both groups showed significant improvement in terms of CAIT scores. |
| Kim and Heo 30 | VR strengthening exercises | VR balance programs | – | 20 min/d, 3 d/wk. for 4 wks. | Balance using Biodex Balance System | Intervention group 1 showed significant improvement regarding static balance in the ML direction and the overall dynamic balance. Intervention group 2 showed significant improvement in the 3 directions of static balance and overall and AP dynamic balance. |
| Vernadakis et al 34 | XbK balance games | Mini trampoline and inflatable discs exercises | NO exercise at all | 24 min/d, 2 d/wk. for 10 wks. | Balance using Biodex Stability System | OSI and LOS scores showed significant improvement for both experimental groups but showed no improvement in the control group. |
| Kim and Gang 27 | Ankle kinesio tapping accompanied with VR strengthening and balance programs. | - | No exercise at all | 20 min/d, 3 d/wk. for 4 wks. | Balance using Biodex balance system | The 3 dynamic balance indexes showed significant improvement in the interventional group, while the 3 static balance indexes showed no improvement. |
| Kim et al 29 | VR strengthening exercises | VR balance programs | – | 20 min/d, 3 d/wk. for 4 wks. | • Ankle proprioception using Biodex isokinetic Dynamometer • Ankle Instability using CAIT |
Proprioception in the sagittal and horizontal planes showed significant improvement in experimental group 2 group but no improvement in experimental group 1. CAIT scores showed significant improvement in both groups. |
Abbreviations: AP, anterior-posterior; CAIT, Cumberland ankle instability tool; d, day; DF, dorsiflexion DF; FAA, foot and ankle ability; FAAM, foot and ankle ability measure; LOS, limit of stability; min, minutes; ML, medio-lateral; OSI, overall stability index; PF, plantar flexion; TRI, traditional rehabilitation interventions; VAS, visual analogue scale; VR, virtual reality; wk, week; XBk, Xbox Kinect.