Task-specific virtual reality training on hemiparetic upper extremity in patients with stroke

Abstract

Task-specific training has been proven to be effective in promoting recovery of the hemiparetic upper extremities after a stroke. This study was to develop a task-specific VR (TS-VR) program using a leap motion controller device and the Unity3D game engine to promote recovery of the hemiparetic upper extremity in patients with stroke based on a hierarchy of seven functional tasks in the functional test for the hemiplegic upper extremity (FTHUE). The final version of the TS-VR was tested on 20 patients suffering from chronic stroke with upper-extremity hemiparesis over 2 weeks, 5 sessions per week, 30 min per session. Outcomes were assessed using the Fugl-Meyer assessment-upper extremity score (FMA-UE), the Wolf motor function test (WMFT), and the motor activity log (MAL) at the first (week 0), last (week 2), and follow-up sessions (week 5). Patients’ arm impairments were stratified into lower (levels 1–4) and higher (levels 5–7) functioning groups according to the FTHUE. Significant improvements were found after TS-VR training in FMA-UE total score and its subscores, and WFMT score among the three time occasions (p = 0.000), but no significant effect on grip strength was found. The higher-functioning group benefited more from the TS-VR, as indicated in outcome measures as well as amount of use score in MAL, but this was not the case for those in the lower-functioning group. Our findings show the TS-VR training was useful for upper-extremity recovery in patients with chronic stroke. It has potential to be applied in clinical settings in future.