title: Developing Home-Based Virtual Reality Therapy Interventions.
abstract: OBJECTIVE
  Stroke is one of the leading causes of serious long-term disability. However, home exercise programs given at rehabilitation often lack in motivational aspects. The purposes of this pilot study were (1) create individualized virtual reality (VR) games and (2) determine the effectiveness of VR games for improving movement in upper extremities in a 6-week home therapy intervention for persons with stroke.
  
  
  METHODS
  Participants were two individuals with upper extremity hemiparesis following a stroke. VR games were created using the Looking Glass programming language and modified based on personal interests, goals, and abilities. Participants were asked to play 1 hour each day for 6 weeks. Assessments measured upper extremity movement (range of motion and Action Research Arm Test [ARAT]) and performance in functional skills (Canadian Occupational Performance Measure [COPM] and Motor Activity Log [MAL]).
  
  
  RESULTS
  Three VR games were created by a supervised occupational therapist student. The participants played approximately four to six times a week and performed over 100 repetitions of movements each day. Participants showed improvement in upper extremity movement and participation in functional tasks based on results from the COPM, ARAT, and MAL.
  
  
  CONCLUSIONS
  Further development in the programming environment is needed to be plausible in a rehabilitation setting. Suggestions include graded-level support and continuation of creating a natural programming language, which will increase the ability to use the program in a rehabilitation setting. However, the VR games were shown to be effective as a home therapy intervention for persons with stroke. VR has the potential to advance therapy services by creating a more motivating home-based therapy service.
authors.affiliation: 1 Program in Occupational Therapy, Washington University School of Medicine , St. Louis, Missouri.
authors.forename: Janice
authors.initials: J
authors.lastname: Lin
authors.affiliation: 2 Department of Computer Science and Engineering, Washington University in St. Louis , St. Louis, Missouri.
authors.forename: Caitlin L
authors.initials: CL
authors.lastname: Kelleher
authors.affiliation: 1 Program in Occupational Therapy, Washington University School of Medicine , St. Louis, Missouri.
authors.forename: Jack R
authors.initials: JR
authors.lastname: Engsberg