Virtual reality (VR) based balance training utilizes immersive digital environments to enhance balance and stability through interactive and engaging exercises. Patients wear VR headsets that create realistic scenarios where they perform various balance tasks, such as navigating virtual obstacles or maintaining stability on unstable surfaces. This technology offers the advantage of providing controlled, adjustable challenges that can be tailored to the patient's specific needs and progress. VR training often incorporates real-time feedback, which helps patients improve their balance in a motivating and dynamic setting.

Traditional physical therapy-based balance training focuses on improving stability and preventing falls through a variety of exercises and techniques. It typically begins with a comprehensive assessment to identify balance issues and set individualized goals. The training includes static exercises like single-leg stands, dynamic activities such as walking on uneven surfaces, and strengthening and flexibility exercises to enhance muscle control and range of motion. Coordination and functional training, including gait and daily activity simulation, are also integral. Additionally, patients receive education on fall prevention strategies and home safety. Regular monitoring ensures that the program is adjusted to the patient's progress and ongoing needs, ultimately enhancing balance and reducing fall risk.

In VR training patients use VR headsets to engage in virtual environments for 8 weeks where they perform exercises designed to enhance balance, coordination, and strength. Simultaneously, the VR platform incorporate pulmonary exercises that focus on improving breathing techniques, lung capacity, and overall respiratory health. Patients will engage in 3 sessions per week with total time duration of 45 to 60 minutes. VR-based training provides real-time feedback and adapts to the patient's progress, offering a comprehensive approach to rehabilitation that addresses both balance and pulmonary function in a motivating and controlled manner.

Berg Balance Scale (BBS) is used to assess balance. It consists of a 14 item that evaluates a persons performance on particular functional task.

The Six Minute Walk Test (SMWT) is a widely used tool for assessing functional exercise capacity, especially in populations with pulmonary and cardiovascular conditions. The test is performed under controlled conditions with the patient encouraged to perform at their own pace and take breaks if needed. the distance covered is measured and any change in condition or symptoms are noted.

Peak expiratory flow rate (PEFR) Peak expiratory flow rate (PEFR) measured through digital spirometer. Peak Expiratory Flow Rate (PEFR) measured through digital spirometer. Three zones of measurement are commonly used to interpret peak flow rates. Normal value of PEFR is (80-100%). Green zone indicates 80 to 100 percent of the usual or normal peak flow reading, yellow zone indicates 50 to 79 percent of the usual or normal peak flow readings, and red zone indicates less than 50 percent of the usual or normal peak flow readings

Forced vital capacity (FVC) measured through digital spirometer. If the value of FVC is within 80% of the reference value, the results are considered normal.

Forced expiratory volume in 1sec (FEV1) measured through digital spirometer. If the value of FEV1 is within 80% of the reference value, the results are considered normal.