Virtual reality (VR) training has gained widespread use in stroke rehabilitation because it can foster brain plasticity and support functional recovery. This study evaluated the impact of treadmill-based gait training incorporating VR with real-time feedback on motor function, balance, and spatiotemporal gait variables among individuals with chronic stroke. Fifteen chronic stroke patients (n = 15) were randomly allocated to either an experimental group (n = 8) receiving treadmill gait training with VR-based real-time feedback or a control group (n = 7) undergoing standard treadmill gait training. The experimental group utilized a treadmill, Oculus Rift VR headset, and smart insoles during sessions. Participants in this group engaged in 30-minute training sessions three times per week for 5 weeks while wearing the VR device. The control group performed treadmill walking for an equivalent duration without VR. Motor function was assessed with the Fugl-Meyer Assessment. Balance was evaluated using the Timed Up and Go test and Berg Balance Scale. Gait parameters were measured via the Optogait system. Data normality was checked with the Shapiro–Wilk test; within-group changes were analyzed using the Wilcoxon signed-rank test, and between-group differences with the Mann–Whitney U test. Both groups demonstrated significant gains in motor function, balance, and gait performance. However, the experimental group exhibited markedly greater improvements compared to the control group in Fugl-Meyer scores (4.75 vs. 1.57, P < 0.05), Timed Up and Go test (−3.10 vs. −1.12 s), Berg Balance Scale (3.00 vs. 1.71), affected step length (5.35 vs. 2.01 cm), stride length (3.86 vs. 1.75 cm), affected single support time (2.61% vs. 1.22%), and cadence (0.07 vs. 0.02 steps/min) (all P < 0.05). Findings indicate that integrating real-time VR feedback during treadmill gait training yields superior benefits for motor function, balance, and gait performance in post-stroke patients.
