Stroke Rehabilitation Using Virtual Environments

Abstract

This review covers the rationale, mechanisms, and availability of commercially available virtual environment-based interventions for stroke rehabilitation. It describes interventions for motor, speech, cognitive, and sensory dysfunction. Also discussed are the important features and mechanisms that allow virtual environments to facilitate motor relearning. A common challenge is the inability to translate success in small trials to efficacy in larger populations. The heterogeneity of stroke pathophysiology has been blamed, and experts advocate for the study of multimodal approaches. Therefore, this article also introduces a framework to help define new therapy combinations that may be necessary to address stroke heterogeneity.

Keywords: Hemiparesis; Motor relearning; Neuroplasticity; Stroke; Virtual reality.

Figure 1

General system-level framework to identify mechanistic targets for multimodal approaches to stroke rehabilitation. The unfilled boxes are example interventions that point to the processes they directly affect, which are represented by filled boxes. The contents of each process are examples and not comprehensive. Red arrows represent intervention effects and blue arrows represent outputs from each process and input into the next process.