Non-immersive Virtual Reality Rehabilitation Applied to a Task-oriented Approach for Stroke Patients: A Randomized Controlled Trial.

BACKGROUND: Virtual reality (VR) training allows the creation of the most applicable practice environment incorporated into computer-generated multisensory imagery. OBJECTIVES: The purpose of this study was to investigate the effects of a virtual training program based on a RAPAEL smart glove on the upper extremity function and quality of life of community-dwelling individuals with chronic hemiparetic stroke. METHODS: Thirty-six outpatients diagnosed as having a first stroke were selected to receive a therapeutic rehabilitation program at local rehabilitation units. Participants were allocated randomly into two groups: the non-immersive VR training (intervention) group and the recreational activity (control) group. The intervention group received non-immersive VR training using a RAPAEL smart glove for 30 minutes per session, 3 days a week for 8 weeks. The control group performed recreational activities for the same period and also participated in a conventional rehabilitation program for 30 minutes per session, 3 days a week for 8 weeks as an additional therapy. To analyze the effects of the non-immersive VR intervention on upper extremity function, four clinical measures, namely the box-block test (BBT), the Wolf motor function test (WMFT), the Jebsen-Taylor hand function test (JTT), and a grip strength test, were used in this study. For the secondary clinical outcome, the trail-making test (TMT) was used to determine any improvement in cognitive function. RESULTS: At week 8, upon completion of the non-immersive VR-training the intervention group demonstrated significantly greater WMFT scores (73.0+/-12.9 to 81.6+/-7.5), BBT scores (27.3+/-8.9 to 34.2+/-7.1), and grip strength (19.2+/-8.2 to 23.8+/-8.5) compared with WMFT scores (70.4+/-12.1 to 73.2+/-13.1), BBT scores (27.1+/-10.5 to 28.8+/-12.9), and grip strength (18.4+/-4.2 to 18.3+/-4.9) in the control group. CONCLUSIONS: This study suggests that virtual upper extremity training using the RAPAEL smart glove has reasonable and beneficial effects on upper extremity and cognitive function for chronic hemiparetic stroke survivors.