Virtual Reality–Augmented Rehabilitation for Patients Following Stroke

TLDR

Intensive massed practice is required to modify neural organization and recover motor skills after stroke. The study employed a 2‑week, 3.5‑hour‑daily VR training program that delivered interactive, motivating exercises targeting range of motion, speed, fractionation, and force to retrain upper‑limb movement. Three chronic stroke patients showed gains in thumb and finger range of motion, speed, fractionation, and strength, with two improving on the Jebsen Test, suggesting VR can augment upper‑limb rehabilitation.

Abstract

Recent evidence indicates that intensive massed practice may be necessary to modify neural organization and effect recovery of motor skills in patients following stroke. Virtual reality (VR) technology has the capability of creating an interactive, motivating environment in which practice intensity and feedback can be manipulated to create individualized treatments to retrain movement.Three patients (ML, LE, and DK), who were in the chronic phase following stroke, participated in a 2-week training program (3 1/2 hours a day) including dexterity tasks on real objects and VR exercises. The VR simulations were targeted for range of motion, movement speed, fractionation, and force production.ML's function was the most impaired at the beginning of the intervention, but showed improvement in the thumb and fingers in range of motion and speed of movement. LE improved in fractionation and range of motion of his thumb and fingers. DK made the greatest gains, showing improvement in range of motion and strength of the thumb, velocity of the thumb and fingers, and fractionation. Two of the 3 patients improved on the Jebsen Test of Hand Function.The outcomes suggest that VR may be useful to augment rehabilitation of the upper limb in patients in the chronic phase following stroke.