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From Wii to Therapy: Can Virtual Reality Improve Recovery After TBI?

March 11, 2021

There’s a reason virtual reality games like those played with a Wii are so popular. They’re fun. And they make working out more exciting. That’s the loose premise behind a new research study at Craig that’s bringing traditional treadmill therapy to life for individuals recovering from traumatic brain injury.

Virtual and augmented reality in combination with treadmill training have shown promise in helping people recover after stroke, but this combination hasn’t been studied in those with traumatic brain injury. That is, until now. Craig Hospital is researching whether or not using augmented reality in combination with treadmill training is safe, feasible, and effective to promote recovery after traumatic brain injury.

The standard-of-care for mobility training after traumatic brain injury is performing balance and movement tasks, such as maintaining a steady gait and turning your head while walking over ground. Treadmill training is also used regularly after traumatic brain injury.

“The study compares three therapy conditions: treadmill training alone, treadmill training enhanced with augmented reality, and standard physical therapy,” says Candy Tefertiller, PT, DPT, PhD, NCS, Executive Director of Research and Evaluation. “If the study has positive results, it will inform clinical care and power future studies here at Craig and possibly impact the care provided to individuals with TBI around the nation.”

Craig recently acquired a C-Mill treadmill with a suite of virtual and augmented reality applications. The treadmill will be used to carry out the study. It comes with a safety harness that supports patients as needed for safety so they can start therapy as soon as possible for best results.

“There are different applications using a combination of a TV screen at the front of the treadmill and projections directly on the treadmill. In one, you move side to side collecting ingredients for a pizza. In another, you play with a soccer ball,” says Katie Hays, physical therapist. “Patients really enjoy the virtual reality treadmill. I find that if I have them walking the halls they get tired within a few minutes and want a rest. On the C-Mill, they tend to go much longer, even 10 to 15 minutes, before wanting a break.”

Thirty participants—people who have sustained a traumatic brain injury in the past—will complete 12 sessions of walking and balance training using one of the three therapies. Results between the study groups will then be compared using the Community Balance and Mobility (CB&M) scale, walking tests, gait symmetry measurements, and more.

“It’s rewarding to watch patients feel good about their accomplishments in therapy. If we can get them walking longer and walking better—and feeling like they have a new option to try when progress has slowed—is really exciting,” Hays says.

Researchers hypothesize that at the end of the study those receiving virtual reality may demonstrate greater improvements in balance, endurance, and attention than those who receive treadmill training or overground training. The Craig Foundation is sponsoring the study. Thanks to generous donors, a good portion of the study has been funded, but donations are still needed. If you’d like to support research at Craig, the Foundation welcomes gifts at all levels.

“When you come to Craig, you expect top notch rehab care. Research is one way we provide new, leading-edge care that can really make a difference in the lives of someone with a spinal cord or traumatic brain injury,” Tefertiller says.

Want to participate?

If you are one year or more out from a TBI, have balance impairments, and are between the ages of 18-65, you may be eligible to participate in the VR treadmill study. To learn more, email Katie Hays at or Candy Tefertiller at or call 303-789-8264.