Feasibility and effectiveness of virtual reality mediated exer-gaming program on upper extremity functions in hemiplegia: A randomized controlled pilot study.

Abstract

Background: Functional impairments in the upper extremities of stroke patients lead to significant limitations in quality of life and independence. Technological developments can create effective treatment alternatives in neurological rehabilitation in upper extremity rehabilitation.

Purpose: The aim of this study was to evaluate the feasibility and effectiveness of a virtual reality (VR)-mediated gamified upper extremity rehabilitation program added to traditional rehabilitation in patients with hemiplegia.

Study design: Randomized-controlled-pilot trial METHODS: Twenty-nine participants with hemiplegia were enrolled in this study between May 2023 and January 2024. Participants were randomized into two groups: VR group (n=15) and control group (n=14). All participants received a conventional rehabilitation program. In addition, participants in the VR group received 20 sessions (45 min each session) of a gamified upper extremity exercise program with a non-immersive VR system, while participants in the control group received 20 sessions (45 min each session) of a home exercise program. The primary outcomes were recruitment rate, dropout rate, safety and adherence. Fugl-Meyer Assessment, Functional Independence Scale (motor subscale), hand grip strength (dynamometer) and Stroke Impact Scale were used as secondary outcome measures. Results are reported using descriptive statistics integrated with qualitative findings.

Results: The study included 3.4 stroke patients per month, with a dropout rate of 7%. There were no serious adverse events associated with the VR-mediated upper limb rehabilitation program. The adherence rate of the participants in the VR group was 96%. Group median values in secondary outcome measures (FMA, FIM, handgrip strength, SIS) showed positive changes at 1 and 3 months after the intervention.

Conclusion: The VR-mediated upper extremity rehabilitation program in stroke patients was safe and showed high adherence, adequate recruitment and dropout rates. Therefore, a definitive study with a higher number of participants can be conducted.