Highlights
- •Virtual reality training improves upper extremity motion and dexterity in chronic stroke patients.
- •Virtual reality system elicited a higher degree of enjoyment from chronic stroke patients.
- •Sensor-based virtual reality games did not show positive effect on quality of life.
Abstract
Background
PABLO is a virtual reality game where a motion sensor system is used. Few studies
have investigated the effects of the PABLO system in stroke rehabilitation. We investigated
the effects of upper-extremity virtual reality training with the PABLO system in patients
with stroke.
Methods
Stroke patients were randomly assigned to the virtual reality (n = 19) or standard rehabilitation groups (n = 18). Total of 18 sessions were conducted twice per week. The primary outcome measure
was the Fugl–Meyer Assessment-Upper Extremity subscale. Secondary outcome measures
included the active ranges of motion of the shoulder and elbow, the box and block
test, hand grip strength, and the Stroke Impact Scale. Enjoyment of activities and
side effects were also recorded.
Findings
No difference was observed between two groups in primary outcome. Virtual reality
group exhibited greater improvements in the hand dexterity between groups (p = .05). In active motion, virtual reality group showed greater improvement in shoulder
flexion between groups (p = .03). Virtual reality group also showed greater improvements in elbow pronation
between groups (p = .03). The groups differed in their assessments of how enjoyment
the rehabilitation activities were found (p = .01). No significant differences between groups were observed in any other tests.
Interpretation
Interventions based on the PABLO virtual reality system improved upper extremity hand
function, shoulder and elbow movements, and elicited a higher degree of enjoyment
from study participants, than did traditional treatment.
Trials registration: The study protocol was registered at Clinical Trials.gov PRS (No.NCT04296032).
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinical BiomechanicsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The effects of virtual reality on upper limb function in chronic stroke patients: a clinical trial.Iran. Rehabil. J. 2019; 17: 81-89https://doi.org/10.32598/irj.17.1.89
- The effects of virtual reality on upper limb function in chronic stroke patients: a clinical trial.17(1). 2019: 81-89
- Training modalities in robot-mediated upper limb rehabilitation in stroke: a framework for classification based on a systematic review.J. Neuroeng. Rehabil. 2014; 11: 1-15https://doi.org/10.1186/1743-0003-11-111
- A study regarding the results of a rehabilitation program in patients with traumatic lesions of the hand after surgery.Palestrica Third Millennium Civilization Sport. 2013; 14: 263-270
- The stroke impact scale 3.0: evaluation of acceptability, reliability, and validity of the Brazilian version.Stroke. 2008; 39: 2477-2484https://doi.org/10.1161/STROKEAHA.107.513671
- Feasibility, acceptability, and efficacy of virtual reality training for older adults and people with disabilities: single-arm pre-post study.J. Med. Internet Res. 2021; 23e27640https://doi.org/10.2196/27640
- Test-retest reproducibility and smallest real difference of 5 hand function tests in patients with stroke.Neurorehabil. Neural Repair. 2009; 23: 435-440https://doi.org/10.1177/1545968308331146
- Augmented efficacy of intermittent theta burst stimulation on the virtual reality-based cycling training for upper limb function in patients with stroke: a double-blinded, randomized controlled trial.J. NeuroEng. Rehabil. 2021; 18: 1-14https://doi.org/10.1186/s12984-021-00885-5
- Mobile game-based virtual reality program for upper extremity stroke rehabilitation.J. Vis. Exp. 2018; 133e56241https://doi.org/10.3791/56241
- Validity and reliability of inertial sensors for elbow and wrist range of motion assessment.PeerJ. 2020; 8e9687https://doi.org/10.7717/peerj.9687
- Task-specific virtual reality training on hemiparetic upper extremity in patients with stroke.2021: 1-12https://doi.org/10.1007/s10055-021-00583-6
- Measurement of grip strength: validity and reliability of the sphygmomanometer and jamar grip dynamometer.J. Orthopaed. Sports Phys. Ther. 1992; 16: 215-219https://doi.org/10.2519/jospt.1992.16.5.215
- The recovery of walking in stroke patients: a review.Int. J. Rehabil. Res. 2010; 33: 285-289https://doi.org/10.1097/MRR.0b013e32833f0500
- Effectiveness of virtual reality-and gaming-based interventions for upper extremity rehabilitation poststroke: a meta-analysis.Arch. Phys. Med. Rehabil. 2020; 101: 885-896https://doi.org/10.1016/j.apmr.2019.10.195
- Closed-chain rehabilitation for upper and lower extremities.J. Am. Acad. Orthop. Surg. 2001; 9: 412-421
- Effects of a virtual reality video game exercise program on upper extremity function and daily living activities in stroke patients.J. Phys. Ther. Sci. 2018; 30: 1408-1411https://doi.org/10.1589/jpts.30.1408
- Clinical application of virtual reality for upper limb motor rehabilitation in stroke: review of technologies and clinical evidence.J. Clin. Med. 2020; 9: 3369https://doi.org/10.3390/jcm9103369
- The incorporation of effect size in information technology, learning, and performance research.Inf. Technol. Learn. Perform. J. 2003; 21: 1-7
- Virtual reality for stroke rehabilitation.Cochrane Database Syst. Rev. 2017, Nov 20; 11: Cd008349https://doi.org/10.1002/14651858.CD008349.pub4
- Virtual reality for stroke rehabilitation.Stroke. 2018; 49: e160-e161
- Virtual reality rehabilitation with functional electrical stimulation improves upper extremity function in patients with chronic stroke: a pilot randomized controlled study.Arch. Phys. Med. Rehabil. 2018; 99: 1447-1453https://doi.org/10.1016/j.apmr.2018.01.030
- Kinect-based individualized upper extremity rehabilitation is effective and feasible for individuals with stroke using a transition from clinic to home protocol.5(1). 2018: 1428038https://doi.org/10.1080/2331205X.2018.1428038
- The efficacy of balance training with video game-based therapy in subacute stroke patients: a randomized controlled trial.Biomed. Res. Int. 2014; 2014580861https://doi.org/10.1155/2014/580861
- Stroke: causes and clinical features.Medicine. 2020; 48: 561-566https://doi.org/10.1016/j.mpmed.2020.06.002
- Psychometric evaluation of the physical activity enjoyment scale in adults with functional limitations.Issues Mental Health Nurs. 2016; 37: 164-171https://doi.org/10.3109/01612840.2015.1088904
- Assessment of movement quality in robot-assisted upper limb rehabilitation after stroke: a review.J. Neuroeng. Rehabil. 2014; 11: 1-23https://doi.org/10.1186/1743-0003-11-137
- Feasibility and preliminary efficacy of a combined virtual reality, robotics and electrical stimulation intervention in upper extremity stroke rehabilitation.J. Neuroeng. Rehabil. 2021; 18: 1-10https://doi.org/10.1186/s12984-021-00851-1
- Counting repetitions: an observational study of video game play in people with chronic poststroke hemiparesis.J. Neurol. Phys. Ther. 2013; 37: 105-111https://doi.org/10.1097/NPT.0b013e31829ee9bc
- Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer test, action research arm test and box and block test: a multicentre study.Clin. Rehabil. 2005; 19: 404-411https://doi.org/10.1191/0269215505cr832oa
- Efficacy and safety of non-immersive virtual reality exercising in stroke rehabilitation (EVREST): a randomised, multicentre, single-blind, controlled trial.Lancet Neurol. 2016; 15: 1019-1027https://doi.org/10.1016/S1474-4422(16)30121-1
- Effect of a four-week virtual reality-based training versus conventional therapy on upper limb motor function after stroke: A multicenter parallel group randomized trial.13(10). 2018https://doi.org/10.1371/journal.pone.0204455 (e0204455)
- Monitoring of visuomotor coordination in healthy subjects and patients with stroke and Parkinson's disease: an application study using the PABLOR-device.Int. J. Neurorehab. 2014; 1: 1-8https://doi.org/10.4172/2376-0281.1000113
- Can non-immersive virtual reality improve physical outcomes of rehabilitation?.Phys. Ther. Rev. 2012; 17: 1-15https://doi.org/10.1179/1743288X11Y.0000000047
- Effect of immersive virtual reality-based bilateral arm training in patients with chronic stroke.Brain Sci. 2021; 11: 1032https://doi.org/10.3390/brainsci11081032
- Effects of contralesional robot-assisted hand training in patients with unilateral spatial neglect following stroke: a case series study.J. Neuroeng. Rehabil. 2014; 11: 1-6https://doi.org/10.1186/1743-0003-11-160
- The effect of Xbox Kinect intervention on balance ability for previously injured young competitive male athletes: a preliminary study.Phys. Ther. Sport. 2014; 15: 148-155https://doi.org/10.1016/j.ptsp.2013.08.004
- Virtual reality as a method for evaluation and therapy after traumatic hand surgery.Annu. Rev. Cyberther. Telemed. 2013; 191: 48-52https://doi.org/10.3233/978-1-61499-282-0-48
- Validity and reliability of an inertial measurement unit-based 3D angular measurement of shoulder joint motion.J. Korean Phys. Ther. 2017; 29: 145-151https://doi.org/10.18857/jkpt.2017.29.3.145
Article info
Publication history
Accepted:
March 9,
2023
Received:
December 13,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
