Effect of Immersive Virtual Reality-Based Bilateral Arm Training in Patients with Chronic Stroke

Abstract

Virtual reality (VR)-based therapies are widely used in stroke rehabilitation. Although various studies have used VR techniques for bilateral upper limb training, most have been only semi-immersive and have only been performed in an artificial environment. This study developed VR content and protocols based on activities of daily living to provide immersive VR-based bilateral arm training (VRBAT) for upper limb rehabilitation in stroke patients. Twelve patients with chronic stroke were randomized to a VRBAT group or a normal bilateral arm training (NBAT) group and attended 30-min training sessions five times a week for four weeks. At the end of the training, there was a significant difference in upper limb function in both groups (p < 0.05) and in the upper limb function sensory test for proprioception in the NBAT group (p < 0.05). There was no significant between-group difference in upper limb muscle activity after training. The relative alpha and beta power values for electroencephalographic measurements were significantly improved in both groups. These findings indicate that both VRBAT and NBAT are effective interventions for improving upper limb function and electroencephalographic activity in patients with chronic stroke.

Effects of virtual reality-based motor control training on inflammation, oxidative stress, neuroplasticity and upper limb motor function in patients with chronic stroke: a randomized controlled trial

“…Evidence exists for the effectiveness of using an immersive VR system in motor control training. Song and Lee have developed VR activities with immersive VR systems to provide bilateral arm training in patients with stroke [ 9 ]. They found that both the immersive VR-based bilateral arm training group and the normal bilateral arm training group showed significant differences in upper limb function between pre- and post-test, without significant differences between groups [ 9 ].…”

“…Song and Lee have developed VR activities with immersive VR systems to provide bilateral arm training in patients with stroke [ 9 ]. They found that both the immersive VR-based bilateral arm training group and the normal bilateral arm training group showed significant differences in upper limb function between pre- and post-test, without significant differences between groups [ 9 ]. Ögün et al conducted a randomized control trial to examine the effectiveness of Leap Motion-based 3D immersive VR system on upper limb function in patients with ischemic stroke [ 10 ].…”

Neurorehabilitation of the upper extremity – Immersive virtual reality vs. robot-assisted training. A comparative study

“…Earlier randomized-controlled studies on the efficacy of iVR-based arm trainings showed that the delivery of practice, i.e. whether the exercises were displayed and performed in iVR (unsupervised) or in a standard occupational therapy setting (in a dose-matched manner), did not significantly affect the outcome, in that both groups improved equally 26–28 . Thus, it has been argued that the benefit of including iVR-based trainings in neurorehabilitation lies primarily in the possibility to increase training intensity (time and/or frequency) by translating established therapeutic concepts into iVR to provide unsupervised self-training.…”

“…Moreover, iVR generally allows the continuation of training after hospital discharge when used in the conceptual framework of tele-rehabilitation. This is particularly relevant as stroke patients benefit from a continuation of therapy at home which can be accomplished by iVR-based training 28 embedded in a rather smooth transition from the rehab facility to patients` home.…”

Combining physical and virtual worlds for motor-cognitive training interventions: Position paper with guidelines on technology classification in movement-related research

“…Study 2 (Song and Lee, 2021) • Red column. Tasks to improve upper limb function using HMD: classified as VR.…”