TY - JOUR
T1 - Virtual Reality for Upper Limb Rehabilitation in Subacute and Chronic Stroke
T2 - A Randomized Controlled Trial
AU - Kiper, Pawel
AU - Szczudlik, Andrzej
AU - Agostini, Michela
AU - Opara, Jozef
AU - Nowobilski, Roman
AU - Ventura, Laura
AU - Tonin, Paolo
AU - Turolla, Andrea
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Objective: To evaluate the effectiveness of reinforced feedback in virtual environment (RFVE) treatment combined with conventional rehabilitation (CR) in comparison with CR alone, and to study whether changes are related to stroke etiology (ie, ischemic, hemorrhagic). Design: Randomized controlled trial. Setting: Hospital facility for intensive rehabilitation. Participants: Patients (N=136) within 1 year from onset of a single stroke (ischemic: n=78, hemorrhagic: n=58). Interventions: The experimental treatment was based on the combination of RFVE with CR, whereas control treatment was based on the same amount of CR. Both treatments lasted 2 hours daily, 5d/wk, for 4 weeks. Main Outcome Measures: Fugl-Meyer upper extremity scale (F-M UE) (primary outcome), FIM, National Institutes of Health Stroke Scale (NIHSS), and Edmonton Symptom Assessment Scale (ESAS) (secondary outcomes). Kinematic parameters of requested movements included duration (time), mean linear velocity (speed), and number of submovements (peak) (secondary outcomes). Results: Patients were randomized in 2 groups (RFVE with CR: n=68, CR: n=68) and stratified by stroke etiology (ischemic or hemorrhagic). Both groups improved after treatment, but the experimental group had better results than the control group (Mann-Whitney U test) for F-M UE (P<.001), FIM (P<.001), NIHSS (P≤.014), ESAS (P≤.022), time (P<.001), speed (P<.001), and peak (P<.001). Stroke etiology did not have significant effects on patient outcomes. Conclusions: The RFVE therapy combined with CR treatment promotes better outcomes for upper limb than the same amount of CR, regardless of stroke etiology.
AB - Objective: To evaluate the effectiveness of reinforced feedback in virtual environment (RFVE) treatment combined with conventional rehabilitation (CR) in comparison with CR alone, and to study whether changes are related to stroke etiology (ie, ischemic, hemorrhagic). Design: Randomized controlled trial. Setting: Hospital facility for intensive rehabilitation. Participants: Patients (N=136) within 1 year from onset of a single stroke (ischemic: n=78, hemorrhagic: n=58). Interventions: The experimental treatment was based on the combination of RFVE with CR, whereas control treatment was based on the same amount of CR. Both treatments lasted 2 hours daily, 5d/wk, for 4 weeks. Main Outcome Measures: Fugl-Meyer upper extremity scale (F-M UE) (primary outcome), FIM, National Institutes of Health Stroke Scale (NIHSS), and Edmonton Symptom Assessment Scale (ESAS) (secondary outcomes). Kinematic parameters of requested movements included duration (time), mean linear velocity (speed), and number of submovements (peak) (secondary outcomes). Results: Patients were randomized in 2 groups (RFVE with CR: n=68, CR: n=68) and stratified by stroke etiology (ischemic or hemorrhagic). Both groups improved after treatment, but the experimental group had better results than the control group (Mann-Whitney U test) for F-M UE (P<.001), FIM (P<.001), NIHSS (P≤.014), ESAS (P≤.022), time (P<.001), speed (P<.001), and peak (P<.001). Stroke etiology did not have significant effects on patient outcomes. Conclusions: The RFVE therapy combined with CR treatment promotes better outcomes for upper limb than the same amount of CR, regardless of stroke etiology.
KW - Feedback
KW - Rehabilitation
KW - Stroke
KW - Virtual reality
UR - http://www.scopus.com/inward/record.url?scp=85046031964&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85046031964&partnerID=8YFLogxK
U2 - 10.1016/j.apmr.2018.01.023
DO - 10.1016/j.apmr.2018.01.023
M3 - Article
C2 - 29453980
AN - SCOPUS:85046031964
VL - 99
SP - 834-842.e4
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
SN - 0003-9993
IS - 5
ER -