title: Virtual reality for the rehabilitation of the upper limb motor function after stroke: a prospective controlled trial.
abstract: BACKGROUND
  Recent evidence has demonstrated the efficacy of Virtual Reality (VR) for stroke rehabilitation nonetheless its benefits and limitations in large population of patients have not yet been studied.
  
  
  OBJECTIVE
  To evaluate the effectiveness of non-immersive 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.
  
  
  METHODS
  A pragmatic clinical trial was conducted among post-stroke patients admitted to our rehabilitation hospital. We enrolled 376 subjects who had a motor arm subscore on the Italian version of the National Institutes of Health Stroke Scale (It-NIHSS) between 1 and 3 and without severe neuropsychological impairments interfering with recovery. Patients were allocated to two treatments groups, receiving combined VR and upper limb conventional (ULC) therapy or ULC therapy alone. The treatment programs consisted of 2 hours of daily therapy, delivered 5 days per week, for 4 weeks. The outcome measures were the Fugl-Meyer Upper Extremity (F-M UE) and Functional Independence Measure (FIM) scales.
  
  
  RESULTS
  Both treatments significantly improved F-M UE and FIM scores, but the improvement obtained with VR rehabilitation was significantly greater than that achieved with ULC therapy alone. The estimated effect size of the minimal difference between groups in F-M UE and FIM scores was 2.5 ± 0.5 (P < 0.001) pts and 3.2 ± 1.2 (P = 0.007) pts, respectively.
  
  
  CONCLUSIONS
  VR rehabilitation in post-stroke patients seems more effective than conventional interventions in restoring upper limb motor impairments and motor related functional abilities.
  
  
  BACKGROUND
  Italian Ministry of Health IRCCS Research Programme 2590412.
authors.affiliation: I.R.C.C.S. Fondazione Ospedale San Camillo, Via Alberoni, 70-30126 Venezia-Lido, Italy. andrea.turolla@ospedalesancamillo.net
authors.forename: Andrea
authors.initials: A
authors.lastname: Turolla
authors.forename: Mauro
authors.initials: M
authors.lastname: Dam
authors.forename: Laura
authors.initials: L
authors.lastname: Ventura
authors.forename: Paolo
authors.initials: P
authors.lastname: Tonin
authors.forename: Michela
authors.initials: M
authors.lastname: Agostini
authors.forename: Carla
authors.initials: C
authors.lastname: Zucconi
authors.forename: Pawel
authors.initials: P
authors.lastname: Kiper
authors.forename: Annachiara
authors.initials: A
authors.lastname: Cagnin
authors.forename: Lamberto
authors.initials: L
authors.lastname: Piron
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*; D063367:Virtual Reality Exposure Therapy / Q000379:methods*
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