title: Virtual reality for upper extremity rehabilitation in early stroke: a pilot randomized controlled trial.
abstract: OBJECTIVE
  To investigate the effect of virtual reality (VR) rehabilitation on upper extremity motor performance of patients with early stroke.
  
  
  METHODS
  Pilot randomized controlled trial.
  
  
  METHODS
  Rehabilitation wards.
  
  
  METHODS
  Twenty three adults with stroke (mean age (SD) = 58.35 (13.45) years and mean time since stroke (SD) = 16.30 (7.44) days).
  
  
  METHODS
  Participants were randomly assigned to VR group (n=11) or control group (n=12). VR group received nine 30 minutes upper extremity VR therapy in standing (five weekdays in two weeks) plus conventional therapy, which included physical and occupational therapy. Control group received only conventional therapy, which was comparable to total training time received by VR group (mean training hours (SD):VR = 17.07 (2.86); control = 15.50 (2.79)).
  
  
  METHODS
  The main outcome measure was the Fugl-Meyer Assessment (FMA). Secondary outcomes included Action Research Arm Test, Motor Activity Log and Functional Independence Measure. Results were taken at baseline, post intervention and 1-month post intervention. Participants' feedback and adverse effects were recorded.
  
  
  RESULTS
  All participants improved in FMA scores (mean change (SD) = 11.65 (8.56), P<.001). These effects were sustained at one month after intervention (mean (SD) change from baseline = 18.67 (13.26), P<.001). All other outcome measures showed similar patterns. There were no significant differences in improvement between both groups. Majority of the participants found VR training useful and enjoyable, with no serious adverse effects reported.
  
  
  CONCLUSIONS
  Although additional VR training was not superior to conventional therapy alone, this study demonstrates the feasibility of VR training in early stroke.
authors.affiliation: Allied Health Division, Department of Occupational Therapy, Singapore General Hospital, Singapore yetta.chan.w.y@sgh.com.sg.
authors.forename: Chan Wai
authors.initials: CW
authors.lastname: Yin
authors.affiliation: Division of Medicine, Department of Rehabilitation Medicine, Singapore General Hospital, Singapore.
authors.forename: Ng Yee
authors.initials: NY
authors.lastname: Sien
authors.affiliation: Allied Health Division, Department of Physiotherapy, Singapore General Hospital, Singapore.
authors.forename: Low Ai
authors.initials: LA
authors.lastname: Ying
authors.affiliation: Division of Research, Health Services Research and Biostatistics, Centre for Quantitative Medicine, Duke-NUS, Singapore General Hospital, Singapore.
authors.forename: Stephanie Fook-Chong Man
authors.initials: SF
authors.lastname: Chung
authors.affiliation: Allied Health Division, Department of Physiotherapy, Singapore General Hospital, Singapore.
authors.forename: Dawn
authors.initials: D
authors.lastname: Tan May Leng
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D000368:Aged; D061345:Early Medical Intervention; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods*; D010865:Pilot Projects; D020127:Recovery of Function; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D018709:Statistics, Nonparametric; D020521:Stroke / Q000175:diagnosis; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*; D063367:Virtual Reality Exposure Therapy / Q000379:methods*
keywords: Rehabilitation; stroke; upper extremity (arm); virtual reality