The Feasibility of Virtual Reality to Provide Visual Feedback to Correct Lower Extremity Biomechanics: A Descriptive Retrospective Case Series

Authors

Margaret R. Klausing, Midwestern UniversityFollow
Kylie Scott, Midwestern UniversityFollow

Abstract

Purpose: This study explored the feasibility of using the Computer Assisted Rehabilitation Environment (CAREN) to enhance visual biofeedback for patients with lower quarter pain, aiming to improve awareness of faulty movement patterns. Methods: Six patients aged 19-66 (3 males, 3 females), with lower quarter pain involving the ankles, knees, or hips completed one session in an outpatient orthopedic setting using CAREN. The motion capture system projected an avatar onto a 180-degree screen, providing visual biofeedback from sagittal and frontal planes. Joint angles, Knee dominant squat (KDS), and Dynamic Q-Angle (DQA) were compared pre- and post-biofeedback during gait and squats. KDS was measured in the sagittal plane, and DQA in the transverse plane. Results: Improvements were noted in sagittal plane biomechanics, particularly in KDS, with a 66-year-old female showing an 8-degree improvement in left ankle plantarflexion during gait. Across all remaining patients, 77% of the data indicated positive trends in joint angle improvements for KDS during squats, while only 22% showed improvements for DQA. Three patients received biofeedback in both planes, with 71% showing improvement in KDS (53% in the sagittal plane, 46% in the frontal plane), but only 23% showed improvements for DQA (67% sagittal, 33% frontal). Conclusions and Recommendations: CAREN demonstrated potential for enhancing biomechanics and motor learning during gait and squats, supporting its clinical feasibility, though limitations were found in improving DQA, particularly for patients with knee pain. Further research, process standardization, and larger-scale studies are recommended to optimize outcomes.

Author Bio(s)

Margaret R. Klausing, PT, DPT, MSCI, is a Board-Certified Orthopedic Clinical Specialist and Assistant Professor in the Doctor of Physical Therapy program at Midwestern University, Glendale, AZ. She is also a licensed physical therapist in the state of Arizona.

Kylie Scott, PT, DPT, EdD, is a Board Certified Orthopedic Clinical Specialist and Associate Professor in the Doctor of Physical Therapy program at Midwestern University in Glendale, AZ. She is also a licensed physical therapist in the state of Arizona.

Acknowledgements

Authors would like to thank Midwestern University for its commitment to advancing patient care in the rehabilitation sciences and providing opportunities for clinical researchers to utilize such unique technology to contribute to the understanding of this growing field. Also, authors wish to acknowledge the contributions of biomedical engineer William Denton for his expertise in operating the CAREN system, providing thorough reports of the data of interest, and working with clinicians across all disciplines to help provide excellent patient-centered care.

Recommended Citation

Klausing MR, Scott K. The Feasibility of Virtual Reality to Provide Visual Feedback to Correct Lower Extremity Biomechanics: A Descriptive Retrospective Case Series. The Internet Journal of Allied Health Sciences and Practice. 2025 Oct 15;23(4), Article 17.