Effects of task-specific virtual reality training using a Leap Motion Controller on hemiparetic upper extremity in patients with stroke

Abstract

Background: Task-specific training has been proven to be effective in promoting recovery of the hemiparetic upper extremities after a stroke. This study was to develop a new and innovative task-specific VR (TS-VR) program using a Leap Motion Controller VR device and the Unity3D program for distal hand function training, and to investigate whether a two-week program of TS-VR training would promote recovery of the hemiparetic upper extremity in patients with chronic stroke.Methods: We designed the TS-VR program based on seven general hand function tasks used in the activities of daily living that require upper limb movement, such as pushing open a door and pouring water. Then, we examined the content validity of the TS-VR according to the views of an expert panel and through field testing on patients with stroke. The final version of the TS-VR was tested on 20 patients suffering from chronic stroke with upper extremity hemiparesis over 2 weeks, 5 sessions per week, 30 minutes per session. Outcomes were assessed using the Fugl-Meyer Assessment-Upper Extremity score (FMA-UE), the Wolf Motor Function Test (WMFT), and the Motor Activity Log (MAL). Data were collected at the first session (week 0), last session (week 2), and follow-up session (week 5). Patients’ arm impairments were stratified into lower- and higher-functioning groups according to the Functional Test for the Hemiplegic Upper Extremity (FTHUE).Results: Significant improvements in upper extremity functions were found after TS-VR training in FMA-UE Total score (χ2=34.219, p=0.000), FMA-UL subscore (χ2=31.2, p=0.000), FMA-Hand subscore (χ2=22.6, p=0.000), and WFMT score (χ2=27.8, p=0.000) among the three time occasions, but no significant effect on grip strength was found. Moreover, the higher-functioning group (levels 5-7 in FTHUE) benefited more from the TS-VR, as indicated in outcome measures of FMA-UL, FMA-Hand, FMA-UE Total, and WMFT respectively, as well as amount of use score in MAL, but this was not the case for those in the lower-functioning group (levels 1-4 in FTHUE).Conclusions: Our findings suggest that our new TS-VR training system was useful for upper extremity recovery in patients with chronic stroke. It has potential to be applied in clinical settings in future.

Proposal for a Sensory Integration Self-system based on an Artificial Intelligence Speaker for Children with Developmental Disabilities: Pilot Study

“…In a study conducted with Leap Motion Controller (LMC, Leap Motion, Inc., San Francisco, CA, USA) by implementing the box and block test (BBT), an OT tool that evaluates hand motor ability in VR, it was confirmed that the conventional BBT and system BBT in a virtual space showed similar performance results, and the objective analysis was possible based on the data collected by tracking the real-time movement [19]. VR helps the user focus on virtual space by eliminating distractions in their surroundings and leaving only the performance environment [23]. This removes spatial constraints so that users can perform in any space and increase their immersion, and good results can be expected in terms of performance.…”

“…Unity3D is a game engine that provides an intuitive graphical user interface (GUI) and a development environment of 2D and 3D [23]. Currently, it is actively used in various fields such as 3D animation, VR, and augmented reality (AR).…”