Enhancing Upper Limb Rehabilitation of Stroke Patients With Virtual Reality: A Mini Review

Abstract

Upper limb motor impairment following stroke is a common condition that impacts significantly the independence and quality of life of stroke survivors. In recent years, scholars have massively turned to virtual reality (VR) to develop more effective rehabilitation approaches. VR systems are promising tools that can help patients engage in intensive, repetitive and task-oriented practice using new technologies to promote neuroplasticity and recovery. Multiple studies have found significant improvements in upper limb function for patients using VR in therapy, but the heterogeneity of methods and tools employed make the assessment of VR efficacy difficult. Here we aimed to assess the potential of VR as a therapy tool for upper limb motor impairment and to provide initial assessment of what is the added value of using VR to both patients and clinicians. Our mini-review focuses the work published since the Cochrane review (2017) and suggests that VR may be particularly effective when used in combination to conventional rehabilitation approaches. We also highlight key features integrated in VR systems that appear to influence rehabilitation and can help maximizing therapy outcomes, if exploited properly. We conclude that although promising results have already been gathered, more focused research is needed to determine the optimal conditions to implement VR in clinical settings in order to enhance therapy and to better define and leverage the true potential of VR. The rapid pace of technological development and increasing research interest toward VR-based therapy will help providing extensive knowledge and lead to rapid advancements in the near future.

Feasibility and Efficacy of a Virtual Reality Game-Based Upper Extremity Motor Function Rehabilitation Therapy in Patients with Chronic Stroke: A Pilot Study

“…The heterogeneity of methods and instruments used in studies of VR in stroke patients sometimes hinders the evaluation of the efficacy of this therapy. In the review of Bui et al [ 3 ], it is concluded that the combination of VR with conventional therapy may be particularly effective in the treatment of the UE in stroke. Another review [ 46 ], on the other hand, justifies that the use of VR does not lead to improvements in manual dexterity in stroke patients.…”

“…The involvement of the upper extremity (UE) appears in up to 85% of patients who survive a stroke, affecting their quality of life [ 2 ]. The recovery of the motor function of the UE is essential in the development of ADLs, but it is also the origin of the difficulty of their recovery, as many of these activities require the coordinated use of both hands [ 3 ]. Furthermore, the complexity of its recovery, compared to the lower limb, underlies the fact that the main functional objective of the UE is the interaction between the individual and the environment in an efficient way, and for this, it is necessary to be able to move the hand in space performing reaching movements, subsequently being able to manipulate, grasp and develop various activities [ 3 , 4 ].…”

Effects of Virtual Reality Therapy and Range of Motion Exercise on Range of Motion in Stroke Patients: Meta-Analysis

“…Virtual Reality Therapy (VRT) is a useful rehabilitation intervention tool for the functional recovery of stroke patients (Bui et al, 2021). VR therapy, specifically designed for upper limb rehabilitation, can improve their hand dexterity, arm function, and independence in carrying out their daily activities after 4 weeks of treatment (Schuster-Amft et al, 2018).…”

A scoping review to assess the effects of virtual reality in medical education and clinical care

“… 1 One of the industries where VR has made a significant impact is healthcare, where VR has proved its potential benefits in medical training, clinical evaluation, and healthcare care delivery. 2 – 5 Due to the emergence of COVID-19 pandemic, the educators were looking for the alternate solutions for medical education and training instead of the traditional face-to-face teaching methods due to the social distancing restrictions. Given the lack of supervision and ideal practice situations, medical and healthcare trainees had few opportunities to practice vocational skills during their clinical rotations.…”