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ORIGINAL PAPER
Impact of a virtual reality program on post-stroke upper limb function: a randomized controlled trial
1
Physical Therapy Department, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Kingdom of Saudi Arabia
2
Department of Physical Therapy for Neuromuscular Disorders & its Surgery, Faculty of Physical Therapy, Cairo University, Egypt
3
Biomechanics Department, Faculty of Physical Therapy, Cairo University, Egypt
Submission date: 2020-04-11
Acceptance date: 2020-11-30
Publication date: 2022-04-21
Physiother Quart. 2022;30(4):81-86
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Motor function after stroke may be facilitated by the application of task-oriented approach which provides both functional and neurological recovery than otherwise possible. Also, virtual reality training promotes the restoration of movements by immersing the patient in an entertaining trial of performance.
Methods:
To compare between the effect of virtual reality training program and task-oriented training program on the paretic upper limb function post stroke. Twenty subacute stroke survivors participated in the study. Participants were randomly allocated into one of two equal groups of 10; experimental group (A) and control group (B). Experimental group (A) performed a virtual reality program and task-oriented program, while Control group (B) performed task-oriented program only. Assessment was done for all participants using upper limb function index and grip strength test before (pre testing) and after six weeks of intervention (post testing).
Results:
Paired t-test revealed that Virtual reality training group (Experimental group A) had statistical significant increases in the post testing mean values (after six weeks of intervention) of both upper limb functional index and hand grip strength compared to the pre testing values (p < 0.05). Furthermore, independent t-test showed a statistical significant increases in their post testing mean values in the experimental group A compared to the control group B.
Conclusions:
The virtual reality training has a vital role in improving upper limb function and augmenting hand grip strength post stroke. It can be considered more effective than task-oriented in such cases.
Motor function after stroke may be facilitated by the application of task-oriented approach which provides both functional and neurological recovery than otherwise possible. Also, virtual reality training promotes the restoration of movements by immersing the patient in an entertaining trial of performance.
Methods:
To compare between the effect of virtual reality training program and task-oriented training program on the paretic upper limb function post stroke. Twenty subacute stroke survivors participated in the study. Participants were randomly allocated into one of two equal groups of 10; experimental group (A) and control group (B). Experimental group (A) performed a virtual reality program and task-oriented program, while Control group (B) performed task-oriented program only. Assessment was done for all participants using upper limb function index and grip strength test before (pre testing) and after six weeks of intervention (post testing).
Results:
Paired t-test revealed that Virtual reality training group (Experimental group A) had statistical significant increases in the post testing mean values (after six weeks of intervention) of both upper limb functional index and hand grip strength compared to the pre testing values (p < 0.05). Furthermore, independent t-test showed a statistical significant increases in their post testing mean values in the experimental group A compared to the control group B.
Conclusions:
The virtual reality training has a vital role in improving upper limb function and augmenting hand grip strength post stroke. It can be considered more effective than task-oriented in such cases.
REFERENCES (33)
1.
Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet. 2014;383(9913): 245–254; doi: 10.1016/s0140-6736(13)61953-4.
2.
Au-Yeung SSY, Hui-Chan CWY. Predicting recovery of dextrous hand function in acute stroke. Disabil Rehabil. 2009;31(5):394–401; doi: 10.1080/09638280802061878.
3.
Nijland RHM, van Wegen EEH, Harmeling-van der Wel BC, Kwakkel G. Presence of finger extension and shoulder abduction within 72 hours after stroke predicts functional recovery: early prediction of functional outcome after stroke: the EPOS cohort study. Stroke. 2010; 41(4):745–750; doi: 10.1161/STROKEAHA.109.572065.
4.
Coupar F, Pollock A, van Wijck F, Morris J, Langhorne P. Simultaneous bilateral training for improving arm function after stroke. Cochrane Database Syst Rev. 2010;2010(4): CD006432; doi: 10.1002/14651858.CD006432.pub2.
5.
Pollock A, Farmer SE, Brady MC, Langhorne P, Mead GE, Mehrholz J, et al. Interventions for improving upper limb function after stroke. Cochrane Database Syst Rev. 2014; 2014(11):CD010820; doi: 10.1002/14651858.CD010820. pub2.
6.
Holmgren E, Gosman-Hedström G, Lindström B, Wester P. What is the benefit of a high-intensive exercise program on health-related quality of life and depression after stroke? A randomized controlled trial. Adv Physiother. 2010;12(3):125–133; doi: 10.3109/14038196.2010. 488272.
7.
Langhammer B, Sunnerhagen KS, Lundgren-Nilsson Å, Sällström S, Becker F, Stanghelle JK. Factors enhancing activities of daily living after stroke in specialized rehabilitation: an observational multicenter study within the Sunnaas International Network. Eur J Phys Rehabil Med. 2017;53(5):725–734; doi: 10.23736/S1973-9087.17.04 489-6.
8.
Bosch J, O’Donnell MJ, Barreca S, Thabane L, Wishart L. Does task-oriented practice improve upper extremity motor recovery after stroke? A systematic review. ISRN Stroke. 2014;2014:504910; doi: 10.1155/2014/504910.
9.
Winstein CJ, Wolf SL, Dromerick AW, Lane CJ, Nelsen MA, Lewthwaite R, et al. Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE): a randomized controlled trial protocol. BMC Neurol. 2013;13(1):5; doi: 10.1186/1471-2377-13-5.
10.
Beaulieu L-D, Milot M-H. Changes in transcranial magnetic stimulation outcome measures in response to upper-limb physical training in stroke: a systematic review of randomized controlled trials. Ann Phys Rehabil Med. 2018;61(4):224–234; doi: 10.1016/j.rehab.2017. 04.003.
11.
Thomas LH, French B, Coupe J, McMahon N, Connell L, Harrison J, et al. Repetitive task training for improving functional ability after stroke: a major update of a Cochrane review. Stroke. 2017;48(4):e102–e103; doi: 10.1161/STROKEAHA.117.016503.
12.
Laver KE, Lange B, George S, Deutsch JE, Saposnik G, Crotty M. Virtual reality for stroke rehabilitation. Cochrane Database Syst Rev. 2017;11(11):CD008349; doi: 10.1002/ 14651858.CD008349.pub4.
13.
Mazurek J, Kiper P, Cieślik B, Rutkowski S, Mehlich K, Turolla A, et al. Virtual reality in medicine: a brief overview and future research directions. Hum Mov. 2019;20(3): 16–22; doi: 10.5114/hm.2019.83529.
14.
Fluet GG, Merians AS, Qiu Q, Rohafaza M, VanWingerden AM, Adamovich SV. Does training with traditionally presented and virtually simulated tasks elicit differing changes in object interaction kinematics in persons with upper extremity hemiparesis? Top Stroke Rehabil. 2015; 22(3):176–184; doi: 10.1179/1074935714Z.0000000008.
15.
Huang Q, Wu W, Chen X, Wu B, Wu L, Huang X, et al. Evaluating the effect and mechanism of upper limb motor function recovery induced by immersive virtual-realitybased rehabilitation for subacute stroke subjects: study protocol for a randomized controlled trial. Trials. 2019; 20(1):104; doi: 10.1186/s13063-019-3177-y.
16.
Hayward KS, Kramer SF, Thijs V, Ratcliffe J, Ward NS, Churilov L, et al. A systematic review protocol of timing, efficacy and cost effectiveness of upper limb therapy for motor recovery post-stroke. Syst Rev. 2019;8(1):187; doi: 10.1186/s13643-019-1093-6.
17.
Kim W-S, Cho S, Ku J, Kim Y, Lee K, Hwang H-J, et al. Clinical application of virtual reality for upper limb motor rehabilitation in stroke: review of technologies and clinical evidence. J Clin Med. 2020;9(10):3369; doi: 10.3390/ jcm9103369.
18.
Ansari NN, Naghdi S, Arab TK, Jalaie S. The interrater and intrarater reliability of the Modified Ashworth Scale in the assessment of muscle spasticity: limb and muscle group effect. NeuroRehabilitation. 2008;23(3):231–237; doi: 10.3233/NRE-2008-23304.
19.
Chesworth BM, Hamilton CB, Walton DM, Benoit M, Blake TA, Bredy H, et al. Reliability and validity of two versions of the Upper Extremity Functional Index. Physiother Can. 2014;66(3):243–253; doi: 10.3138/ptc.2013-45.
20.
Binkley JM, Stratford P, Kirkpatrick S, Farley CR, Okoli J, Gabram S. Estimating the reliability and validity of the Upper Extremity Functional Index in women after breast cancer surgery. Clin Breast Cancer. 2018;18(6):e1261– e1267; doi: 10.1016/j.clbc.2018.02.008.
21.
Amaral JF, Mancini M, Novo Júnior JM. Comparison of three hand dynamometers in relation to the accuracy R.M. Hegazy, A.M. Alkhateeb, A.M. Abdelmohsen Virtual reality program after stroke 86 Physiother Quart 2022, 30(4) and precision of the measurements. Rev Bras Fisioter. 2012;16(3):216–224; doi: 10.1590/s1413-35552012000 300007.
22.
Perez-Marcos D, Chevalley O, Schmidlin T, Garipelli G, Serino A, Vuadens P, et al. Increasing upper limb training intensity in chronic stroke using embodied virtual reality: a pilot study. J Neuroeng Rehabil. 2017;14(1):119; doi: 10.1186/s12984-017-0328-9.
23.
Ahn S, Hwang S. Virtual rehabilitation of upper extremity function and independence for stoke: a meta-analysis. J Exerc Rehabil. 2019;15(3):358–369; doi: 10.12965/ jer.1938174.087.
24.
Aminov A, Rogers JM, Middleton S, Caeyenberghs K, Wilson PH. What do randomized controlled trials say about virtual rehabilitation in stroke? A systematic literature review and meta-analysis of upper-limb and cog - nitive outcomes. J Neuroeng Rehabil. 2018;15(1):29; doi: 10.1186/s12984-018-0370-2.
25.
Bergmann J, Krewer C, Bauer P, Koenig A, Riener R, Müller F. Virtual reality to augment robot-assisted gait training in non-ambulatory patients with a subacute stroke: a pilot randomized controlled trial. Eur J Phys Re - habil Med. 2018;54(3):397–407; doi: 10.23736/s1973- 9087.17.04735-9.
26.
Kossut M. Basic mechanism of neuroplasticity [in Polish]. Neuropsychiatr Neuropsychol. 2019;14(1–2):1–8; doi: 10.5114/nan.2019.87727.
27.
Calabrò RS, Naro A, Russo M, Leo A, De Luca R, Bal - letta T, et al. The role of virtual reality in improving motor performance as revealed by EEG: a randomized clinical trial. J Neuroeng Rehabil. 2017;14(1):53; doi: 10.1186/ s12984-017-0268-4.
28.
Thant AA, Wanpen S, Nualnetr N, Puntumetakul R, Chatchawan U, Hla KM, et al. Effects of task-oriented training on upper extremity functional performance in patients with sub-acute stroke: a randomized controlled trial. J Phys Ther Sci. 2019;31(1):82–87; doi: 10.1589/ jpts.31.82.
29.
Athanasiadis D, Protopsaltis S, Stefas E. The effects of mobilization and stimulation of neuromuscular tissue on the hemiplegic upper limb: a case report. Physiother Quart. 2019;27(1):6–11; doi: 10.5114/pq.2019.83055.
30.
Lee S, Kim Y, Lee B-H. Effect of virtual reality-based bilateral upper extremity training on upper extremity function after stroke: a randomized controlled clinical trial. Occup Ther Int. 2016;23(4):357–368; doi: 10.1002/oti.1437.
31.
Lee M, Son J, Kim J, Pyun S-B, Eun SD, Yoon B. Com - parison of individualized virtual reality- and group-based rehabilitation in older adults with chronic stroke in community settings: a pilot randomized controlled trial. Eur J Integr Med. 2016;8(5):738–746; doi: 10.1016/j.eu - jim.2016.08.166.
32.
Kong K-H, Loh Y-J, Thia E, Chai A, Ng C-Y, Soh Y-M, et al. Efficacy of a virtual reality commercial gaming de - vice in upper limb recovery after stroke: a randomized, controlled study. Top Stroke Rehabil. 2016;23(5):333– 340; doi: 10.1080/10749357.2016.1139796.
33.
Afsar S I, Mirzayev I, Yemisci OU, Saracgil SNC. Virtual reality in upper extremity rehabilitation of stroke patients: a randomized controlled trial. J Stroke Cerebrovasc Dis. 2018;27(12):3473–3478; doi: 10.1016/j.jstrokecere - brovasdis.2018.08.007.
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