Effects of Immersive Virtual Reality-Based Movement Therapy on Upper ExtremityFunctions and Cognitive Functions in Stroke Patients

Authors

DOI:

https://doi.org/10.22100/ijhs.v9i3.1092

Keywords:

Cognition , Rehabilitation, Stroke, Upper extremity, Virtual reality

Abstract

Background: This controlled experimental study aimed to investigate the effect of immersive virtual reality-based movement therapy (IVRMT) on upper extremity functions (UEF), activities of daily living (ADL), and cognitive functions (CF) in chronic stroke patients.

Methods: Patients who met the inclusion criteria, were randomly assigned to the study (IVR) or control groups. Both of the groups received 60 minutes/day of conventional rehabilitation program and occupational therapy and the IVR group received 30 minutes/day of additional IVR-MT for six weeks. UEF was evaluated by the Jebsen Taylor Hand Function Test (JTHFT), and the Box and Block Test (BBT), ADL was evaluated by the Barthel Index (BI), and 36-Item Short Form Survey (SF-36), and CF was evaluated with the Mini Mental Test (MMT).

Results: There were no differences between the IVR (n=15), and control (n=10) groups for demographic and clinical characteristics or baseline results of JTHFT, BBT, BI, SF-36, and MMT. At six weeks post-treatment there were significant improvements in the IVR group in scores for moving large light cans (Pvalue=0.001) and moving large heavy cans (Pvalue=0.003) in the JTHFT, in BBT scores (Pvalue=0.004), in MMT (Pvalue=0.033) and for physical functioning (Pvalue=0.008) in the SF-36. In addition, the change in score in the IVR group for moving large light cans (Pvalue=0.008) and moving large heavy cans (Pvalue=0.002) at week 6 was significantly larger than in the control group.

Conclusions: These results suggest that additional IVR-MT, in combination with conventional physiotherapy and occupational therapy might improve outcomes in UEF and CF in chronic stroke patients.

Author Biography

  • Tugba Gokbel, Kocaeli University, Faculty of Medicine, Physical Medicine and Rehabilitation, Kocaeli, Turkey

    0000-0003-2673-9092

References

Balami JS, Chen RL, Buchan AM. Stroke syndromes and clinical management.

QJM 2013;106:607-15. doi:10.1093/qjmed/hct057

Nichols-Larsen DS, Clark PC, Zeringue A, Greenspan A, Blanton S. Factors

influencing stroke survivors' quality of life during subacute recovery. Stroke

;36:1480-4. doi:10.1161/01.STR.0000170706.13595.4f

Mehrholz J, Pohl M, Platz T, Kugler J, Elsner B. Electromechanical and robotassisted

arm training for improving activities of daily living, arm function, and

arm muscle strength after stroke. Cochrane Database Syst Rev

;9:CD006876. doi:10.1002/14651858.CD006876.pub5

Thieme H, Mehrholz J, Pohl M, Behrens J, Dohle C. Mirror therapy for

improving motor function after stroke. Stroke 2013;44:e1-2.

doi:10.1161/strokeaha.112.673087

Saposnik G, Levin M; Outcome Research Canada (SORCan) Working Group.

Virtual reality in stroke rehabilitation: a meta-analysis and implications for

clinicians. Stroke 2011;42:1380-6. doi:10.1161/STROKEAHA.110.605451

Jin M, Pei J, Bai Z, Zhang J, He T, Xu X, Zhu F, et al. Effects of virtual reality

in improving upper extremity function after stroke: A systematic review and

meta-analysis of randomized controlled trials. Clin Rehabil 2022;36:573-596.

doi:10.1177/02692155211066534

Laver KE, Lange B, George S, Deutsch JE, Saposnik G, Crotty M. Virtual

reality for stroke rehabilitation. Cochrane Database Syst Rev

;11:CD008349. doi:10.1002/14651858.CD008349.pub4

Cumming TB, Marshall RS, Lazar RM. Stroke, cognitive deficits, and

rehabilitation: still an incomplete picture. Int J Stroke 2013;8:38-45.

doi:10.1111/j.1747-4949.2012.00972.x

Maier M, Rubio Ballester B, Duff A, Duarte Oller E, Verschure PFMJ. Effect

of specific over nonspecific VR-based rehabilitation on poststroke motor

recovery: A systematic meta-analysis. Neurorehabil Neural Repair

;33:112-129. doi:10.1177/1545968318820169

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 cognitive

outcomes. J Neuroeng Rehabil 2018;15:29. doi:10.1186/s12984-018-0370-2

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:CD010820.

doi:10.1002/14651858.CD010820.pub2

Wu J, Zeng A, Chen Z, Wei Y, Huang K, Chen J, Ren Z. Effects of virtual

reality training on upper limb function and balance in stroke patients:

Systematic review and meta-meta-analysis. J Med Internet Res

;23:e31051. doi:10.2196/31051

Park DS, Lee DG, Lee K, Lee G. Effects of Virtual reality training using xbox

kinect on motor function in stroke survivors: A preliminary study. J Stroke

Cerebrovasc Dis 2017;26:2313-9.

doi:10.1016/j.jstrokecerebrovasdis.2017.05.019

Ahmad MA, Singh DKA, Mohd Nordin NA, Hooi Nee K, Ibrahim N. Virtual

reality games as an adjunct in ımproving upper limb function and general

health among stroke survivors. Int J Environ Res Public Health 2019;16:5144.

doi:10.3390/ijerph16245144

Laffont I, Froger J, Jourdan C, Bakhti K, van Dokkum LEH, Gouaich A, et al.

Rehabilitation of the upper arm early after stroke: Video games versus

conventional rehabilitation. A randomized controlled trial. Ann Phys Rehabil

Med 2020;63:173-80. doi:10.1016/j.rehab.2019.10.009

El-Kafy EMA, Alshehri MA, El-Fiky AA, Guermazi MA. The effect of

virtual reality-based therapy on ımproving upper limb functions in ındividuals

with stroke: A randomized control trial. Front Aging Neurosci

;13:731343. doi:10.3389/fnagi.2021.731343

Ikbali Afsar S, Mirzayev I, Umit Yemisci O, Cosar Saracgil SN. Virtual

reality in upper extremity rehabilitation of stroke patients: A randomized

controlled trial. J Stroke Cerebrovasc Dis 2018;27:3473-8.

doi:10.1016/j.jstrokecerebrovasdis.2018.08.007

Fang Z, Wu T, Lv M, Chen M, Zeng Z, Qian J, et al. Effect of traditional plus

virtual reality rehabilitation on prognosis of stroke survivors: A Systematic

review and meta-analysis of randomized controlled trials. Am J Phys Med

Rehabil 2022;101:217-28. doi:10.1097/PHM.0000000000001775

Chen J, Or CK, Chen T. Effectiveness of using virtual reality-supported

exercise therapy for upper extremity motor rehabilitation in patients with

stroke: Systematic review and meta-analysis of randomized controlled trials. J

Med Internet Res 2022;24:e24111. doi:10.2196/24111

Mekbib DB, Debeli DK, Zhang L, Fang S, Shao Y, Yang W, et al. A novel

fully immersive virtual reality environment for upper extremity rehabilitation

in patients with stroke. Ann N Y Acad Sci 2021;1493:75-89.

doi:10.1111/nyas.14554

Soufi Ahmadi H, Hassani Mehraban A, Amini M, Sheikhi M. The effects of

virtual reality on upper limb function in chronic stroke patients: A clinical trial.

Iranian Rehabilitation Journal 2019;17:81-9.

Leng Y, Lo WLA, Mao YR, Bian R, Zhao JL, Xu Z, et al. The impact of

cognitive function on virtual reality ıntervention for upper extremity

rehabilitation of patients with subacute stroke: Prospective randomized

controlled trial with 6-month follow-up. JMIR Serious Games 2022;10:e33755.

doi:10.2196/33755

Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC, et al;

American heart association stroke council, council on cardiovascular and

stroke nursing, council on clinical cardiology, and council on quality of care

and outcomes research. Guidelines for adult stroke rehabilitation and recovery:

A guideline for healthcare professionals from the American heart

association/American stroke association. Stroke 2016;47:e98-e169.

doi:10.1161/STR.0000000000000098

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Published

2024-03-10

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How to Cite

Effects of Immersive Virtual Reality-Based Movement Therapy on Upper ExtremityFunctions and Cognitive Functions in Stroke Patients. (2024). International Journal of Health Studies (Undergoing Change to Shahroud Journal of Medical Sciences), 9(3), 37-42. https://doi.org/10.22100/ijhs.v9i3.1092