Development of the Home based Virtual Rehabilitation System (HoVRS) to remotely deliver an intense and customized upper extremity training

J Neuroeng Rehabil. 2020 Nov 23;17(1):155. doi: 10.1186/s12984-020-00789-w.


Background: After stroke, sustained hand rehabilitation training is required for continuous improvement and maintenance of distal function.

Methods: In this paper, we present a system designed and implemented in our lab: the Home based Virtual Rehabilitation System (HoVRS). Fifteen subjects with chronic stroke were recruited to test the feasibility of the system as well as to refine the design and training protocol to prepare for a future efficacy study. HoVRS was placed in subjects' homes, and subjects were asked to use the system at least 15 min every weekday for 3 months (12 weeks) with limited technical support and remote clinical monitoring.

Results: All subjects completed the study without any adverse events. Subjects on average spent 13.5 h using the system. Clinical and kinematic data were collected pre and post study in the subject's home. Subjects demonstrated a mean increase of 5.2 (SEM = 0.69) on the Upper Extremity Fugl-Meyer Assessment (UEFMA). They also demonstrated improvements in six measurements of hand kinematics. In addition, a combination of these kinematic measures was able to predict a substantial portion of the variability in the subjects' UEFMA score.

Conclusion: Persons with chronic stroke were able to use the system safely and productively with minimal supervision resulting in measurable improvements in upper extremity function.

Keywords: Serious gaming; Stroke; Telerehabilitation; Upper extremity; Virtual reality.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Biomechanical Phenomena
  • Female
  • Hand / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Physical Therapy Modalities
  • Pilot Projects
  • Recovery of Function*
  • Stroke / physiopathology
  • Stroke Rehabilitation / instrumentation*
  • Stroke Rehabilitation / methods
  • Telerehabilitation / instrumentation*
  • Telerehabilitation / methods
  • Upper Extremity / physiopathology
  • User-Computer Interface*