Category: Stroke; Technology (e.g. robotics, assistive technology, mHealth); Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
Virtual reality is classified as non-immersive, semi-immersive, and fully-immersive depending on the degree of immersion. Among these, the fully-immersive type is a system that allows the user to immerse himself or herself in a live environment using a head mounted display (HMD) and a variety of sensors capable of recognizing the motion of the user. We developed a fully-immersive rehabilitation program using a HMD, and report a preliminary study of applying it to patients with upper extremity dysfunction due to stroke.
Design : A feasibility study
Setting : Institutional practice
Participants (or Animals, Specimens, Cadavers) : Chronic stroke patients
Interventions : The HMD used HTC Vive and the training software was developed in such a way that the user catches and throws the ball thrown in the virtual reality space in sitting position. The training consisted of a total of 10 sessions two to three times a week, consisting of 30 minutes at a time.
Main Outcome Measure(s) : MBI, ARAT, and BBT were measured and compared before and after the training, and satisfaction with upper extremity rehabilitation program using virtual reality was measured by questionnaire
The mean age of the twelve patients (male7) was 40.2 ± 17.8 years and the mean duration of disease was 36.0 ± 61.9 months. Only three patients had ischemic stroke, and the others had hemorrhagic stroke. No adverse effects related to motion sickness, such as nausea and dizziness, were reported during the training session in all patients. Three patients discontinued VR training. Nine patients who completed the training program showed significant improvement in MBI (pre-training 90.4 ± 8.5, post-training 93.0 ± 5.0; P = .042), ARAT (pre-training 22.3 ± 20.1, post-training 31.1 ± 19.6; P = .028), and BBT (pre-training 11.2 ± 16.3, post-training 19.6 ± 29.3; P =.012). Overall satisfaction was 6.3 ± 0.8.
Our preliminary study suggests that fully-immersive rehabilitation program using a HMD can be adopted to chronic stoke patients with upper extremity weakness. This virtual rehabilitation system may increase the brain plasticity through the self-recognition of the body in the virtual space like mirror therapy.
Seung Hak Lee– Assistant professor, Asan Medical Center, Seoul, Seoul-t'ukpyolsi