The objective of this study was to evaluate the effectiveness of non-immersive virtual reality (VR) treatment for the restoration of the upper limb motor function and its impact on the activities of daily living capacities in post-stroke patients. The study rationalised the use of VR for therapeutic intervention, stating that the learning of new motor tasks is dependent on the feedback derived from the performance of the task itself. Virtual reality can provide this feedback about movement characteristics.
The clinical trial included 276 post-stroke patients admitted to a specific rehabilitation hospital. Patients were allocated to two treatment groups receiving combined VR and upper limb conventional therapy, or upper limb conventional therapy alone. The treatment programs consisted of 2 hours of daily therapy, delivered 5 days per week, for 4 weeks.
The outcome measures of this study were the Fugl-Meyer Upper Extremity and the Functional Independence Measure scales. The study found that both treatments significantly improved Fugl-Meyer Upper Extremity scores and Functional Independence Measure scores. However, more significant improvement was obtained with the VR rehabilitation, compared to the patients receiving upper limb conventional therapies alone. As such, this study concluded that VR rehabilitation in post-stroke patients seems more effective than conventional interventions alone in restoring upper limb motor impairments and motor related functional abilities.
Upon analysis of this study, the team at Better Rehabilitation identified several implications of implementing VR interventions with their client base. Firstly, in the study clients received intervention for 2 hours everyday for 5 days a week. This is not a feasible option in the community setting in which we practice, as the intensity of therapy is restricted by client and therapist availability, and client funding. Furthermore, it was identified that not all post -stroke clients would be eligible to completed VR interventions, and each client would need to be assessed and appropriate therapeutic intervention would need to be identified based on clinical option.
This study concluded that VR treatments represent a valuable therapeutic option for clients post-stroke in conjunction with conventional therapies. However, as therapists, we endeavour to continue to investigate the specific VR technologies available, as the results obtained using the VR system used in this specific study may differ to various VR equipment.
Furthermore, upon discussion, the team at Better Rehabilitation identified several limitations to the study, which may have impacted the results obtained. For example, the allocation of clients to control and non-control groups was not completed in a randomised manner. Therefore, the affect of confounding factors to bias the findings of the study are difficult to identify.