title: The effectiveness of reinforced feedback in virtual environment in the first 12 months after stroke.
abstract: OBJECTIVE
  Reinforced feedback in virtual environment (RFVE) therapy is emerging as an innovative method in rehabilitation, which may be advantageous in the treatment of the affected arm after stroke. The purpose of this study was to investigate the impact of assisted motor training in a virtual environment for the treatment of the upper extremity (UE) after stroke compared to traditional neuromotor rehabilitation (TNR), studying also if differences exist related to the type of stroke (haemorrhagic or ischaemic).
  
  
  METHODS
  Eighty patients affected by a stroke (48 ischaemic and 32 haemorrhagic) that occurred at least 1 year before were enrolled. The clinical assessment comprising the Fugl-Meyer UE (F-M UE), modified Ashworth (Bohannon and Smith) and Functional Independence Measure scale (FIM) was administered before and after the treatment.
  
  
  RESULTS
  A statistically significant difference between RFVE and TNR groups (Mann-Whitney U-test) was observed in the clinical outcomes of F-M UE and FIM (both p < 0.001), but not Ashworth (p = 0.053). The outcomes of F-M UE and FIM improved in the RFVE haemorrhagic group and in the TNR haemorrhagic group with a significant difference between groups (both p < 0.001), but not for Ashworth (p = 0.651). Comparing the RFVE ischaemic group to the TNR ischaemic group, statistically significant differences emerged in F-M UE (p < 0.001), FIM (p < 0.001), and Ashworth (p = 0.036).
  
  
  CONCLUSIONS
  The RFVE therapy in combination with TNR showed better improvements compared to the TNR treatment only. The RFVE therapy combined with the TNR treatment was more effective than the TNR double training, in both post-ischaemic and post-haemorrhagic groups. We observed improvements in both groups of patients: post-haemorrhagic and post-ischaemic stroke after RFVE training.
authors: Paweł Kiper, Via Alberoni 70, 30126 Venezia. pawel.kiper@ospedalesancamillo.net
authors: Paweł
authors: P
authors: Kiper
authors: Lamberto
authors: L
authors: Piron
authors: Andrea
authors: A
authors: Turolla
authors: Joanna
authors: J
authors: Stożek
authors: Paolo
authors: P
authors: Tonin
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D003198:Computer Simulation / Q000706:statistics & numerical data*; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000295:instrumentation / Q000379:methods*; D030141:Feedback, Psychological; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use; D017063:Outcome Assessment, Health Care; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation*; D011044:Poland; D020127:Recovery of Function; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*
chemical_list: D009465:Neuromuscular Agents