title: Cortical reorganization and associated functional motor recovery after virtual reality in patients with chronic stroke: an experimenter-blind preliminary study.
abstract: 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.
authors.affiliation: Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Jang
authors.forename: Sung H
authors.initials: SH
authors.lastname: You
authors.forename: Mark
authors.initials: M
authors.lastname: Hallett
authors.forename: Yun Woo
authors.initials: YW
authors.lastname: Cho
authors.forename: Chong-Mi
authors.initials: CM
authors.lastname: Park
authors.forename: Sang-Hyun
authors.initials: SH
authors.lastname: Cho
authors.forename: Hyun-Young
authors.initials: HY
authors.lastname: Lee
authors.forename: Tae-Hoon
authors.initials: TH
authors.lastname: Kim
mesh_terms: 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