Virtual reality-augmented rehabilitation for patients following stroke.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
The outcomes suggest that VR may be useful to augment rehabilitation of the upper limb in patients in the chronic phase following stroke.
Merians
Alma S
AS
Department of Developmental and Rehabilitative Sciences, University of Medicine and Dentistry of New Jersey, 65 Bergen St, Newark, NJ 07103, USA. merians@umdnj.edu
Jack
David
D
Boian
Rares
R
Tremaine
Marilyn
M
Burdea
Grigore C
GC
Adamovich
Sergei V
SV
Recce
Michael
M
Poizner
Howard
H
D000368:Aged; D000369:Aged, 80 and over; D001132:Arm; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008838:Microcomputers; D008875:Middle Aged; D009048:Motor Skills; D026741:Physical Therapy Modalities / Q000295:instrumentation / Q000379:methods; D016059:Range of Motion, Articular; D012985:Software Design; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013813:Therapy, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D013997:Time Factors; D014584:User-Computer Interface