Cortical reorganization and associated functional motor recovery after virtual reality in patients with chronic stroke: an experimenter-blind preliminary study.
OBJECTIVE
To investigate the effects of virtual reality (VR) on cortical reorganization and motor recovery.


METHODS
Nonparametric pre- and posttest design with experimenter blinded.


METHODS
University medical center.


METHODS
Five patients with hemiparesis (age, 59.8+/-3.4y) were recruited.


METHODS
Five patients received VR for 60 minutes a day, 5 times a week for 4 weeks. VR was designed to provide a virtual rehabilitation scene where the intensity of practice and sensory feedback could be systematically manipulated to provide the most appropriate, individualized motor retraining program.


METHODS
Cortical activation and associated motor recovery were measured before and after VR using functional magnetic resonance imaging and standardized motor tests, respectively. Nonparametric tests were used at P less than .05.


RESULTS
Prior to VR, the bilateral primary sensorimotor cortices (SM1s), contralesional premotor cortex, and contralesional or ipsilesional supplementary motor area were activated. After VR, the altered activations disappeared and predominantly the ipsilesional SM1 was activated (P<.05). Motor function was improved (P<.05).


CONCLUSIONS
This is a novel demonstration of VR-induced neuroplastic changes and associated motor recovery in chronic stroke.
Jang
Sung Ho
SH
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.
You
Sung H
SH
Hallett
Mark
M
Cho
Yun Woo
YW
Park
Chong-Mi
CM
Cho
Sang-Hyun
SH
Lee
Hyun-Young
HY
Kim
Tae-Hoon
TH
D000328:Adult; D000368:Aged; D001132:Arm / Q000503:physiopathology; D002540:Cerebral Cortex / Q000473:pathology*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D010291:Paresis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D020127:Recovery of Function / Q000502:physiology; D016037:Single-Blind Method; D020521:Stroke / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D014584:User-Computer Interface