Background: Rehabilitation therapy using a virtual reality (VR) system for stroke patients has gained attention. However, few studies have investigated fully immersive VR using a head-mount display (HMD) for upper extremity rehabilitation in stroke patients.
Objective: To investigate the feasibility, preliminary efficacy, and usability of a fully immersive VR rehabilitation program using a commercially available HMD for upper-limb rehabilitation in stroke patients.
Design: A feasibility study.
Setting: Two rehabilitation centers.
Participants: Twelve stroke patients with upper extremity weakness.
Interventions: Five upper extremity rehabilitation tasks were implemented in a virtual environment, and the participants wore an HMD (HTC Vive) and trained with appropriate tasks. Participants received a total of 10 sessions two to three times a week, consisting of 30 minutes per session.
Main outcome measures: Both patient participation and adverse effects of VR training were monitored. Primary efficacy was assessed using functional outcomes (Action Research Arm Test, Box and Block Test, and modified Barthel Index), before and after the intervention. Usability was assessed using a self-reported questionnaire.
Results: Three patients discontinued VR training, and nine patients completed the entire training sessions and there were no adverse effects due to motion sickness. The patients who received all sessions showed significant functional improvement in all outcome measures after training (P < .05 for all measures). The overall satisfaction was 6.3 ± 0.8 on a 7-point Likert scale in all participants.
Conclusions: A fully immersive VR rehabilitation program using an HMD for rehabilitation of the upper extremities following stroke is feasible and, in this small study, no serious adverse effects were identified.
Level of evidence: IV.
© 2019 American Academy of Physical Medicine and Rehabilitation.
Virtual Reality for Upper Extremity Rehabilitation in Early Stroke: A Pilot Randomized Controlled TrialCW Yin et al. Clin Rehabil 28 (11), 1107-14. PMID 24803644. - Randomized Controlled TrialAlthough additional VR training was not superior to conventional therapy alone, this study demonstrates the feasibility of VR training in early stroke.
Evaluating the Effect and Mechanism of Upper Limb Motor Function Recovery Induced by Immersive Virtual-Reality-Based Rehabilitation for Subacute Stroke Subjects: Study Protocol for a Randomized Controlled TrialQ Huang et al. Trials 20 (1), 104. PMID 30728055.ClinicalTrials.gov, NCT03086889 . Registered on March 22, 2017.
[Virtual Reality in Upper Extremity Dysfunction: Specific Features of Usage in Acute Stroke]MV Dolganov et al. Vopr Kurortol Fizioter Lech Fiz Kult 96 (5), 19-28. PMID 31626156. - Randomized Controlled TrialОбоснование. Инсульт является ведущей причиной стойкой потери трудоспособности. Виртуальная реальность, являясь новой технологией в нейрореабилитации, позволяет обеспечив …
Effectiveness of Virtual Reality- And Gaming-Based Interventions for Upper Extremity Rehabilitation Poststroke: A Meta-analysisR Karamians et al. Arch Phys Med Rehabil. PMID 31821799. - ReviewOverall, VR- or gaming-based upper extremity rehabilitation poststroke appears to be more effective than conventional methods. Further in-depth study of variables affecti …
Virtual Reality in Stroke Rehabilitation: A Systematic Review of Its Effectiveness for Upper Limb Motor RecoveryA Henderson et al. Top Stroke Rehabil 14 (2), 52-61. PMID 17517575. - ReviewThe current evidence on the effectiveness of using VR in the rehabilitation of the UL in patients with stroke is limited but sufficiently encouraging to justify additiona …
Cited by 1 PubMed Central articles
Non-Immersive Virtual Reality for Rehabilitation of the Older People: A Systematic Review Into Efficacy and EffectivenessR Bevilacqua et al. J Clin Med 8 (11). PMID 31694337. - Reviewas it is shown by the numerous studies in the field, the application of VR has a positive impact on the rehabilitation of the most predominant geriatric syndromes. The le …
- Steuer J. Defining virtual reality: characteristics determining telepresence. J Commun. 1992;42:73-94.
- Jack D, Boian R, Merians AS, et al. Virtual reality-enhanced stroke rehabilitation. IEEE Trans Neural Syst Rehabil Eng. 2001;9:308-318. https://doi.org/10.1109/7333.948460.
- Reid DT. Benefits of a virtual play rehabilitation environment for children with cerebral palsy on perceptions of self-efficacy: a pilot study. Pediatr Rehabil. 2002;3:141-148. https://doi.org/10.1080/136384902100003934.
- Haik J, Tessone A, Nota A, et al. The use of video capture virtual reality in burn rehabilitation: the possibilities. J Burn Care Res. 2006;27:195-197. https://doi.org/10.1097/01.BCR.0000200890.34084.76.
- Kockro RA, Amaxopoulou C, Killeen T, et al. Stereoscopic neuroanatomy lectures using a three-dimensional virtual reality environment. Ann Anat. 2015;201:91-98. https://doi.org/10.1016/j.aanat.2015.05.006.