title: Reinforced feedback in virtual environment for rehabilitation of upper extremity dysfunction after stroke: preliminary data from a randomized controlled trial.
abstract: OBJECTIVE
  To study whether the reinforced feedback in virtual environment (RFVE) is more effective than traditional rehabilitation (TR) for the treatment of upper limb motor function after stroke, regardless of stroke etiology (i.e., ischemic, hemorrhagic).
  
  
  METHODS
  Randomized controlled trial. Participants. Forty-four patients affected by stroke. Intervention. The patients were randomized into two groups: RFVE (N = 23) and TR (N = 21), and stratified according to stroke etiology. The RFVE treatment consisted of multidirectional exercises providing augmented feedback provided by virtual reality, while in the TR treatment the same exercises were provided without augmented feedbacks. Outcome Measures. Fugl-Meyer upper extremity scale (F-M UE), Functional Independence Measure scale (FIM), and kinematics parameters (speed, time, and peak).
  
  
  RESULTS
  The F-M UE (P = 0.030), FIM (P = 0.021), time (P = 0.008), and peak (P = 0.018), were significantly higher in the RFVE group after treatment, but not speed (P = 0.140). The patients affected by hemorrhagic stroke significantly improved FIM (P = 0.031), time (P = 0.011), and peak (P = 0.020) after treatment, whereas the patients affected by ischemic stroke improved significantly only speed (P = 0.005) when treated by RFVE.
  
  
  CONCLUSIONS
  These results indicated that some poststroke patients may benefit from RFVE program for the recovery of upper limb motor function. This trial is registered with NCT01955291.
authors.affiliation: Laboratory of Kinematics and Robotics, IRCCS San Camillo Hospital Foundation, Via Alberoni 70, 30126 Venice, Italy.
authors.forename: Paweł
authors.initials: P
authors.lastname: Kiper
authors.affiliation: Laboratory of Kinematics and Robotics, IRCCS San Camillo Hospital Foundation, Via Alberoni 70, 30126 Venice, Italy.
authors.forename: Michela
authors.identifier: 0000-0001-8824-3338
authors.initials: M
authors.lastname: Agostini
authors.affiliation: Laboratory of Kinematics and Robotics, IRCCS San Camillo Hospital Foundation, Via Alberoni 70, 30126 Venice, Italy ; Physiotherapy Department, University of Seville, Calle San Fernando 4, 41004 Seville, Spain ; Motion Analysis Laboratory, "Virgen del Rocio" Hospital, Physiotherapy Area, Avenida Manuel Siurot, 41013 Seville, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Luque-Moreno
authors.affiliation: Laboratory of Kinematics and Robotics, IRCCS San Camillo Hospital Foundation, Via Alberoni 70, 30126 Venice, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Tonin
authors.affiliation: Laboratory of Kinematics and Robotics, IRCCS San Camillo Hospital Foundation, Via Alberoni 70, 30126 Venice, Italy.
authors.forename: Andrea
authors.identifier: 0000-0002-1609-8060
authors.initials: A
authors.lastname: Turolla
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation*; D020521:Stroke / Q000150:complications / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D034941:Upper Extremity / Q000503:physiopathology; D063367:Virtual Reality Exposure Therapy / Q000379:methods*
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