Effects of virtual reality therapy on upper limb function after stroke and the role of neuroimaging as a predictor of a better response

Gonçalves, Maicon Gabriel; Piva, Mariana Floriano Luiza; Marques, Carlos Leonardo Sacomani; Costa, Rafael Dalle Molle da; Bazan, Rodrigo; Luvizutto, Gustavo José; Betting, Luiz Eduardo

doi:10.1590/0004-282x20180104

Cited by 12 publications

(7 citation statements)

References 38 publications

(39 reference statements)

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“…Current research is examining the utility of VR not only as therapy, but also to identify specific patient populations that may benefit from VR, how to best implement the therapies, and to measure and monitor patients' response to interventions. [15][16][17] Another clear benefit to VR-augmented therapy is that, unlike some traditional stroke interventions, which are best applied as soon after the cerebral event as possible, [18] this therapy regimen was implemented 7 years post-stroke, and with essentially no therapies in the intervening years. Despite this, significant mobility gains and quality of life improvements were observed, demonstrating that VR-augmented interventions can potentially benefit many stroke victims, regardless of elapsed time since the stroke.…”

Section: Discussionmentioning

confidence: 99%

Highlighting hybridization: a case report of virtual reality-augmented interventions to improve chronic post-stroke recovery

Bailey¹

2022

Medicine

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Rationale:Cerebrovascular accident, or stroke, is a leading cause of serious long-term disability, and incidence is expected to continue rising in the coming years. Stroke-related disability can manifest as motor, sensory, or cognitive impairment, and although current therapies can improve these impairments, many stroke patients are still left with reduced abilities and struggle to maintain independence in their daily lives. Virtual reality (VR) has been proposed as a novel therapeutic tool to treat stroke-related disability, particularly in conjunction with traditional post-stroke therapies.Patient concerns:Here, we report 1 case of a 75-year-old male with ongoing right upper extremity impairment.Diagnosis:The patient was previously diagnosed with an ischemic stroke.Interventions:Seven years post-stroke, during which he did not receive any therapies, and on the recommendation of his neurologist, the patient sought VR therapy as an innovative treatment strategy. His clinicians employed a combination of traditional exercise and VR therapy to improve his strength and mobility.Outcomes:The combination of traditional and VR therapy was able to provide meaningful improvement to his daily quality of life, even years after the stroke.Conclusions:These results suggest that combination therapy with VR is a viable tool for treating post-stroke impairment, even several years on from the cerebrovascular accident.

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Section: Discussionmentioning

confidence: 99%

Highlighting hybridization: a case report of virtual reality-augmented interventions to improve chronic post-stroke recovery

Bailey¹

2022

Medicine

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“…They randomly selected 12 subjects [23]; in another experimental study, 20 patients [24], where they used VR rehabilitation protocols and compared them to a group that underwent conventional rehabilitation exercises; the VR group was more effective in improving motor impairment and attention, leading the researchers to conclude that combining conventional and virtual rehabilitation is necessary for improving patients' functional outcomes. Several researchers have demonstrated in recent clinical trials with stroke survivors that VR is effective for the rehabilitation of motor function [15,[26][27][28]; performance and independence in activities of daily life [29,30] and dynamic balance [4][5][6]. Also, in one of the largest studies conducted so far, which included 376 patients, it was shown that VR-based rehabilitation was beneficial [31].…”

Section: Related Workmentioning

confidence: 99%

“…Functional magnetic resonance imaging (FMRI) [40] was used to detect brain activation, and the motor function of the affected upper limb was evaluated using the Wolf motor function test (WMFT) [41]. May be one of the benefits of using VR in rehabilitation, is the activation of different brain areas, including the mirror neuron system responsible for motor planning and learning, as shown by studies using electroencephalographic (EEG) oscillation analysis [28,42,43]. However, a study that also utilized EEG analysis found no significant difference in motivation or participation between conventional and VR rehabilitation approaches [44].…”

Section: Related Workmentioning

confidence: 99%

Assessing the Effectiveness of Virtual Reality Serious Games in Post-Stroke Rehabilitation: A Novel Evaluation Method

MASMOUDI,

Zenati,

Izountar

et al. 2023

Preprint

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Background: This paper presents a novel evaluation method for assessing the effectiveness of virtual reality serious games in post-stroke rehabilitation. Stroke, which is a leading cause of long-term disability, requires effective rehabilitation approaches to facilitate motor recovery and enhance patients’ quality of life. The study aims to investigate the potential benefits of incorporating VR technology into upper limb rehabilitation for post-stroke patients, with a specific focus on evaluating patient motivation and engagement. The proposed evaluation method provides insights into the effectiveness of VR serious games as a rehabilitation tool and contributes to the understanding of their impact on post-stroke recovery. Methods: This study involved the recruitment of a diverse sample of 20 patients, both male and female, who had experienced left hemiplegia as a result of an ischemic stroke. To ensure a representative sample, patients of different ages were included. Participants were divided into three groups, with each group invited to participate in different stages over a one-year period. During an eight-week period, all groups participated in a rehabilitation program consisting of virtualreality exercises twice a week, alongside five traditional rehabilitation sessions per week. Furthermore, this study introduces a novel approach using camera-based sensors to evaluate patient engagement in virtual reality exercises. By monitoring and analyzing facial expressions throughout each rehabilitation session, our objective is to leverage emotion recognition technology to understand patients’emotional states and levels of motivation and engagement. Results: The findings from this study indicate that a significant number of patients showed motivation during virtual reality rehabilitation exercises. Conclusion: The analysis of facial expressions utilizing camera-based sensors, yielded valuable insights into the emotional state and level of engagement exhibited by the participants. These findings substantiate the efficacy of virtual reality as a potent tool in fostering motivation among post-stroke patients, thereby actively involving them in rehabilitation exercises and facilitating their journey toward recovery.

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“…VR-based therapy has been used for the rehabilitation of adults with stroke effectively [ 16 , 17 ]. A few studies have investigated the effect of VR intervention in children with CP.…”

Section: Reviewmentioning

confidence: 99%

Virtual Reality-Based Intervention for Enhancing Upper Extremity Function in Children With Hemiplegic Cerebral Palsy: A Literature Review

Goyal¹,

Vardhan²,

Naqvi³

2022

Cureus

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Cerebral palsy (CP) is the most common cause of motor disability in the pediatric population, with hemiplegia as one of the most widely seen subtypes of spastic CP. Although most of the children with hemiplegic CP are independent ambulators, deficits in hand function of the affected side remain a major concern of caregivers and children themselves. Children use the unaffected upper extremity to compensate for the weakness in the affected one, which consequently leads to the disuse of the hemiparetic upper extremity. Interactive virtual environments can enhance the activation of brain areas during training by providing feedback that can catalyze neuroplastic changes for improved function. Although numerous studies have been conducted on the impact of virtual reality (VR)-based rehabilitation in adults with stroke, studies on its use in the pediatric population are scarce. The three broad categories of VR systems based on the type of human-computer interactions are feedback-focused, gesture-based, and haptic-based. Preliminary studies have shown promising results of VR intervention in improving motor function, including upper extremity function, in children with hemiplegic CP. It is an engaging and entertaining intervention that adds an advantage of high compliance due to motivation. The current literature consists of studies with highly heterogeneous groups of participants and small sample sizes. Further investigation on children with a specific type of CP with advanced VR systems technology is warranted.

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Effects of virtual reality therapy on upper limb function after stroke and the role of neuroimaging as a predictor of a better response

Cited by 12 publications

References 38 publications

Highlighting hybridization: a case report of virtual reality-augmented interventions to improve chronic post-stroke recovery

Highlighting hybridization: a case report of virtual reality-augmented interventions to improve chronic post-stroke recovery

Assessing the Effectiveness of Virtual Reality Serious Games in Post-Stroke Rehabilitation: A Novel Evaluation Method

Virtual Reality-Based Intervention for Enhancing Upper Extremity Function in Children With Hemiplegic Cerebral Palsy: A Literature Review

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