[Abstract] Home-based upper extremity stroke therapy using a multi-user virtual reality environment: a randomized trial

Abstract

Objective

To compare participation and subjective experience of participants in both home-based multi-user VR therapy and home-based single-user VR therapy.

Design

Crossover, randomized trial

Setting

Initial training and evaluations occurred in a rehabilitation hospital; the interventions took place in participants’ homes

Participants

Stroke survivors with chronic upper extremity impairment (n=20)

Interventions

4 weeks of in-home treatment using a custom, multi-user virtual reality system (VERGE): two weeks of both multi-user (MU) and single-user (SU) versions of VERGE. The order of presentation of SU and MU versions was randomized such that participants were divided into two groups, first multi-user (FMU) and first single-user (FSU).

Main Outcome Measures

We measured arm displacement during each session (meters) as the primary outcome measure. Secondary outcome measures include: time participants spent using each MU and SU VERGE, and Intrinsic Motivation Inventory (IMI) scores. Fugl-Meyer Upper-Extremity (FMUE) score and compliance with prescribed training were also evaluated. Measures were recorded before, midway, and after the treatment. Activity and movement were measured during each training session.

Results

Arm displacement during a session was significantly affected the mode of therapy (MU: 414.6m, SU: 327.0m, p=0.019). Compliance was very high (99% compliance for MU mode and 89% for SU mode). Within a given session, participants spent significantly more time training in the MU mode than in the SU mode (p=0.04). FMUE score improved significantly across all participants (Δ3.2, p=0.001).

Conclusions

Multi-user VR exercises may provide an effective means of extending clinical therapy into the home.

via Home-based upper extremity stroke therapy using a multi-user virtual reality environment: a randomized trial – Archives of Physical Medicine and Rehabilitation

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