Abstract
Stroke survivors often experience debilitating neural, physical, and cognitive impairments, particularly affecting upper limb functions. Conventional rehabilitations, though effective, are perceived as slow and monotonous by stroke survivors. This review explores the potential of Virtual Reality (VR) as an engaging rehabilitation approach to address such limitations. Our findings show that VR based rehabilitations can be beneficial in restoring post-stroke upper limb functions and improving routine life of survivors. Moreover, VR offers adaptability, and user-friendliness across age groups. However, further research with larger sample size studies and stronger evidence base is needed to definitively establish the effectiveness of VR in post-stroke rehabilitation.
1. Introduction
Cerebral circulation, the blood flow within the brain is crucial for maintaining the proper functioning of human tissues, limbs, and organs. Interruption of this blood flow can result in unconsciousness and irreparable damage to brain cells known as neurons.1 This cessation of blood flow can lead to a stroke, also known as Cardiovascular Accident or Brain Attack, characterized by either reversible or irreversible paralysis. Additional symptoms of stroke include dizziness, loss of consciousness, coma, physical disruption (such as muscle weakness, changes in movement, and coordination issues), cognitive deficits, visual disturbances, urinary complaints, and in severe cases, death.
A stroke can be classified as either ischemic i.e., caused by a disruption in blood flow to the brain due to thrombus or embolus) or hemorrhagic involving the leakage and accumulation of blood in localized areas.2 Stroke represents a medical emergency that often correlates with advancing age, hypertension, high blood cholesterol, and diabetes mellitus. Approximately 20% of acute stroke patients may succumb within a month, and at least 50% of stroke survivors may experience prolonged physical disabilities.3 The effects of stroke are particularly pronounced in the upper extremities (UE) including the upper arm, lower arm, and the hand.
Stroke survivors undergo a variety of progressive and dynamic rehabilitation aimed at restoring their neural, physical, and, cognitive functions. These rehabilitations are diverse and often combine autonomous learning processes4 including restoration, switching and restitution. Consequently, a ‘one size fits all’ rehabilitation approach may not be suitable for every survivor. Instead, a combination of conventional and non-conventional rehabilitations5 may be a more prudent option for managing post-stroke complications.
Rehabilitation plays a crucial role in maintaining or enhancing the functioning and independence of stroke survivors thereby promoting overall health.6 While conventional rehabilitation approaches are effective for many, they are often perceived as monotonous, slow, and exhausting by some users. Recently, Virtual Reality (VR) based rehabilitations have demonstrated their effectiveness in enhancing upper limb (UL) motor functions and activities of daily living (ADL). This is attributed to their innovative approach, flexibility, real-time feedback, and user-friendly interface. VR is perceived as more responsive and interactive by stroke survivors due to its closer resemblance to physical reality.
This review, broadly discusses different types of conventional rehabilitations (CR) and non-conventional rehabilitations (NCR) aimed at restoring post-stroke UE functions. However, the primary focus of this review is on VR based rehabilitations in the form of combination of guided VR and CR, immersive VR, haptic feedback, and VR games all aimed at restoring various aspects of post-stroke UE functions, such as physical impairments, neuronal/cognitive rehabilitation, motor functions, gait disorders, attention deficits, mental perception, anxiety, etc. […]
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Fig. 3. Robotics based rehabilitation.