Effect of Leap Motion-based 3D Immersive Virtual Reality Usage on Upper Extremity Function in Ischemic Stroke Patients

Abstract

Immersive virtual reality (VR) is a technology that provides a more realistic environmental design and object tracking than ordinary VR. The aim of this study was to investigate the effectiveness of immersive VR on upper extremity function in patients with ischemic stroke. Sixty-five patients with ischemic stroke were included in this randomized, controlled, double-blind study. Patients were randomly divided into VR (n = 33) and control (n = 32) groups. The VR group received 60 minutes of the upper extremity immersive VR rehabilitation program and the control group received 45 minutes of conventional therapy and 15 minutes of a sham VR program. Rehabilitation consisted of 18 sessions of therapy, three days per week, for six weeks. The outcome measures were the Action Research Arm Test (ARAT), Functional Independence Measure (FIM), Fugl-Meyer Upper Extremity Scale (FMUE) and Performance Assessment of Self-Care Skills (PASS). In both the VR and control groups all parameters except the PASS improved over time. However independent t-test results showed that all of the FMUE, ARAT, FIM and PASS scores were significantly higher in the VR group compared with the control (p < 0.05). The minimal clinically important difference (MCID) scores of the FMUE and ARAT were higher than the cut-off MCID scores described in the literature in the VR group, whereas the FIM scores were below the cut-off MCID scores. All scores in the control group were below the cut-off scores. Immersive VR rehabilitation appeared to be effective in improving upper extremity function and self-care skills, but it did not improve functional independence.

Head-Mounted Display-Based Therapies for Adults Post-Stroke: A Systematic Review and Meta-Analysis

“…The rankings of all studies but one (Ögün [45]) are available in the PEDro database [37]. The score of the study of Ögün [45] is not yet in PEDro, but the score was obtained by consensus between the authors. The eligibility criteria were clearly satisfied in all of the studies, with the exception of the study of Lee [46], whereas baseline comparability was satisfied in all of the studies.…”

“…In fact, none of the studies fulfilled these two requirements simultaneously. The study of Ögün [45] had patients masked by using sham VR therapy within the control group. The same applies to item 3 (concealed allocation), which was fulfilled by only two studies [47,48].…”

“…It is important to note that one study [47] reached the maximum, and two studies reached 7 out of 8 [46,48]. Five studies reported that the outcome assessors were blinded [45][46][47][48]50]. Five studies reported withdrawals and provided reasons for these dropouts [45][46][47][48]51].…”

Virtual reality in stroke rehabilitation: virtual results or real values?

“…Ogun and colleagues have confirmed our intuition: they found that virtual reality rehabilitation guided by a Leap Motion controller appeared to be effective in improving upper extremity function and self-care skills (but not functional independence), more than conventional therapy, in a wide sample of patients 7 .…”

“…In this scenario, the recent study by Ogun and colleagues clearly shows all the potentials of using a Leap Motion controller interfaced with 3D immersive virtual reality to improve the upper extremity functions in patients with ischemic stroke 7 . The Leap Motion controller is an optical tracking system including three infrared light emitters and two infrared cameras for tracking hand and finger kinematics, interfacing them with a virtual environment developed as a human-computer interface.…”