Effects of Augmented Reality Functional Integrated Training (AR-FIT) on Balance and Mobility in Stroke

Effects of Augmented Reality Functional Integrated Training (AR-FIT) on Balance and Mobility in Stroke

The present study aims to develop and validate an evidence-based functional balance task library for Augmented Reality-Functional Integrated Training (AR-FIT), incorporating standardized real-object integration through expert consensus and pilot usability testing. Furthermore, the study seeks to determine the effects of AR-FIT on balance and functional mobility in stroke survivors in comparison to conventional Augmented Reality & task oriented training over an eight-week intervention period. In addition, it intends to evaluate participant motivation, engagement, and perceived task realism during AR-FIT using structured questionnaires and post-intervention interviews, thereby examining both clinical effectiveness and user-centered experience outcomes.

Stroke remains a leading cause of long-term disability, with its burden rising sharply in low- and middle-income countries such as Pakistan. Despite advances in acute care, many survivors continue to experience persistent balance and mobility impairments that limit independence. While augmented reality (AR) based rehabilitation has shown promise in improving motor recovery and engagement, current AR systems often emphasize generalized or gamified tasks, offering limited opportunities for practicing functionally relevant, real-world movements. Therefore, the current study introduces an Augmented Reality-Functional Interactive Training (AR-FIT), designed to evaluate the feasibility and effectiveness of combining AR-guided feedback with real-object manipulation for post-stroke balance training. The objectives are threefold: first, to determine the feasibility and usability of AR-FIT as a balance training platform; second, to assess its impact on postural control, balance, and functional mobility compared to conventional AR training; and third, to explore patient motivation and engagement associated with tangible, ecologically valid tasks. By enhancing realism, sensory engagement, and functional relevance, this approach is expected to bridge the existing gap between digital rehabilitation technologies and the real-world demands of stroke recovery.

Inclusion Criteria:

• Adults aged 40-70 years with first-ever ischemic or hemorrhagic stroke (>3 months post-onset).
• Cognitive ability: MMSE > 24.
• No or mild spasticity in upper/lower limb MAS ≤ 2
• Functional Ambulation Category (FAC) ≥ 3.
• Berg Balance Scale (BBS) 20-40 (to avoid floor/ceiling effects).
• Ability to walk 10 meters independently
• Willingness to provide informed consent and participate regularly.

Exclusion Criteria:

• Severe musculoskeletal or neurological comorbidities (e.g., contractures, Parkinson's disease).
• Severe visual, neglect, or communication impairments.
• Uncontrolled systemic illness or unstable cardiovascular condition.
• Participation in another interventional trial within the last 3 months.