Stroke: Virtual reality improves motor skills in stroke survivors

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The addition of virtual reality and gaming systems to stroke rehabilitation programs can improve arm strength and motor skills, according to research published April 7 in Stroke: Journal of the American Heart Association.

An analysis of seven observational and five randomized controlled trials (RCTs) that enrolled a total of 195 stroke patients who were aged 26 to 88 years showed that patients saw an average 14.7 percent improvement in motor strength when virtual reality (VR) sessions were integrated into rehabilitation.

In addition, use of VR showed a 20 percent improvement in motor function and ability to perform standard tasks. Within the RCTs, patients who played VR games had a 4.89 times greater chance in improving motor strength compared to those who underwent standard therapy. Additionally, the researchers reported that 11 of the 12 studies showed that VR showed significant benefit.

“Virtual reality gaming therapy may provide an affordable, enjoyable and effective alternative to intensify treatment and promote motor recovery after stroke,” wrote the study’s lead author Gustavo Saposnik, MD, of the St. Michael’s Hospital at the University of Toronto.

Saposnik offered that VR systems can help provide stroke survivors real-time feedback that enhances positive reinforcement and can help with multi-sensorial feedback including vision, hearing and sensory perception, computer-assisted movement and modifiable speed, which can include a wide range of patients including those with cognitive impairment.

Although the studies differed, most patients played VR 20 to 30 hours during their four- to six-week therapy. The gaming systems used included Glasstron, IREX, Playstation Eye Toy and nine VR systems including Virtual Teacher, CyberGlove, VR Motion, PneuGlove and Wii.

“Recovery of motor skill depends on neurological recovery, adaptation and learning new strategies and motor programs,” the authors wrote. “VR systems apply relevant concepts for driving neuroplasticity (i.e., repetition, intensity, and task-oriented training of the paretic extremity) and lead to benefits in motor function improvement after stroke.”

While the researchers wrote that the use of these types of systems could help promote motor recovery after stroke, it may not be useful in all stroke patients, particularly those who underwent more debilitating stroke.

“Larger multi-center randomized trials are needed before making conclusions that might influence clinical practice,” the authors concluded. “The completion of well designed RCTs will ultimately advance knowledge about the optimal rehabilitation strategy for patients with a disabling stroke.”