The Next Steps: Overcoming Locomotor Recovery Plateau in Chronic Post-Stroke Rehabilitation Through Augmented Reality: A Retrospective Case Report

Publication Date

Spring 2026

Document Type

Capstone Project

Degree Name

Doctor of Physical Therapy

Department

Physical Therapy

First Advisor

Maryleen Jones

Second Advisor

Laura Lenhart

Third Advisor

Roberta O'Shea

Abstract

Purpose:

It is noted that stroke survivors experience a plateau effect of motor recovery during the chronic stages of poststroke rehabilitation (>6 months post-onset), often resulting in discharge from physical therapy.12 Few Studies directly address the plateau of motor recovery, despite highlighting the potential underlying theories contributing to decreasing clinically significant improvements of locomotion.12 Recent literature has suggested several benefits through the use of Augmented Reality (AR) devices. 4,7,11,13-20 The purpose of this case study was to explore the immediate and long-term locomotion improvements utilizing an AR device with a patient who had recently been discharged from post-stroke physical therapy due to a plateau during their chronic stage of recovery.

Methods:

Single subject pre- and post-testing of gait metrics, using the STROLL ARTM system for intensive gait training over nine, one-hour training sessions in the span of 11 weeks.

Results:

Patient demonstrated minimal detectable change for the Timed Up and Go (TUG) measure at eight (8) weeks from baseline assessment with and without an assistive device. The patient also demonstrated notable improvements in gait kinematics (measured through Gait Sens 2.0 on the GK S22 Gait Keeper treadmill) of step and stride length, and weight-bearing symmetry, in conjunction with patient-reported satisfaction with their gait performance.

Implications for Practice:

This case study shows promise for both immediate and long-term carryover for improvements in gait metrics for patients with hemiplegia. Further studies are needed to determine the efficacy of AR devices in people with chronic stroke. Effective interventions are necessary for therapists to employ for multiple benefits, including patient satisfaction, joint protection from faulty kinematics, and a decrease in health care costs. no adverse reactions were reported by the patient, demonstrating the feasibility of implementing AR device interventions in people with chronic stroke.

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