Virtual reality based rehabilitation speeds up functional recovery of the upper extremities after stroke: A randomized controlled pilot study in the acute phase of stroke using the Rehabilitation Gaming System

Abstract

Purpose: Given the incidence of stroke, the need has arisen to consider more self-managed rehabilitation approaches. A promising technology is Virtual Reality (VR). Thus far, however, it is not clear what the benefits of VR systems are when compared to conventional methods. Here we investigated the clinical impact of one such system, the Rehabilitation Gaming System (RGS), on the recovery time course of acute stroke. RGS combines concepts of action execution and observation with an automatic individualization of training. Methods. Acute stroke patients (n = 8) used the RGS during 12 weeks in addition to conventional therapy. A control group (n = 8) performed a time matched alternative treatment, which consisted of intense occupational therapy or non-specific interactive games. Results. At the end of the treatment, between-group comparisons showed that the RGS group displayed significantly improved performance in paretic arm speed that was matched by better performance in the arm subpart of the Fugl-Meyer Assessment Test and the Chedoke Arm and Hand Activity Inventory. In addition, the RGS group presented a significantly faster improvement over time for all the clinical scales during the treatment period. Conclusions. Our results suggest that rehabilitation with the RGS facilitates the functional recovery of the upper extremities and that this system is therefore a promising tool for stroke neurorehabilitation.

Facilitating Stroke Management using Modern Information Technology

“…VR systems give sensory feedback to patients, in most cases visual or audio feedback, which can improve patients' cognitive and motor functions. Several studies have shown that VR is beneficial to arm function,54,55 walking,56 and neglect 57,58. However, the Cochrane review stated that there was insufficient evidence for any conclusion on the effectiveness of VR on grip strength or gait speed.…”

Exploring the impact of visual and movement based priming on a motor intervention in the acute phase post-stroke in persons with severe hemiparesis of the upper extremity

“…Two of the three studies used dose-matched controls and noted significant improvement favoring the treatment group in upper extremity function, speed, and impairment. [12–14]…”

Multisensory Stimulation in Stroke Rehabilitation

“…Greater change in velocity and walking distance both in the laboratory and in the community was obtained when the robot was coupled with virtual environments in gait training (Mirelman et al, 2008). Mixing several tasks in one session produced better retention than training only one task, and in acute and sub-acute stages of recovery it would be more effective to focus rehabilitation on restoration of impairment and avoid a premature emphasis on compensation (Huang and Krakauer, 2009; Da Silva Cameirao et al, 2011). Virtual-reality games may enhance the effect of robot training on attention, speed, force, precision, and timing in the arm (Takahashi et al, 2008).…”