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. 2019 Sep;98(9):783-788.
doi: 10.1097/PHM.0000000000001190.

Immersive Virtual Reality Mirror Therapy for Upper Limb Recovery After Stroke: A Pilot Study

Lynne M Weber  1 , Dawn M Nilsen, Glen Gillen, Jin Yoon, Joel Stein
Affiliations

Immersive Virtual Reality Mirror Therapy for Upper Limb Recovery After Stroke: A Pilot Study

Lynne M Weber et al. Am J Phys Med Rehabil. 2019 Sep.

Abstract

Objective: This study was designed to examine the feasibility of immersive virtual reality mirror therapy for upper limb paresis after stroke using a head-mounted display and provide preliminary evidence of efficacy.

Design: Ten outpatients with chronic stroke, upper limb hemiparesis, and a low predisposition for motion sickness completed a 12-session program of 30 mins each of immersive virtual reality mirror therapy. The virtual reality system provided the illusion of movement in the hemiparetic upper limb while suppressing the visual representation of the nonparetic side. Feasibility was assessed via patient compliance, adverse event tracking, the System Usability Scale, and the Simulator Sickness Questionnaire. Preliminary efficacy was evaluated using the Fugl-Meyer Upper Extremity and Action Research Arm Test.

Results: Immersive virtual reality mirror therapy for patients with chronic stroke was safe, well-tolerated, and without adverse events, such as simulator sickness. Motor outcomes revealed a small improvement for the Fugl-Meyer Upper Extremity from 21.7 (SD = 8.68) to 22.8 (SD = 9.19) that did not achieve statistical significance (P = 0.084).

Conclusions: Four weeks of immersive virtual reality mirror therapy was well-tolerated by chronic stroke patients. Our findings support further clinical trials of immersive virtual reality technologies and visually enhanced mirror therapies for stroke survivors.

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Figures

Figure 1:
Figure 1:
System setup for individual with left hemiplegia including laptop computer, tabletop sensors, headset and controller.
Figure 2:
Figure 2:
Comparison of conventional mirror box therapy with immersive virtual reality mirror therapy. Note suppression of the non-paretic upper limb within the enriched virtual environment.
Figure 3:
Figure 3:
Screenshot of shoulder flexion exercise guided by avatar therapist, as seen through virtual reality headset.
Figure 4:
Figure 4:
Screenshot of rock stacking activity, as seen through virtual reality headset.
See this image and copyright information in PMC

References

    1. Benjamin EJ, Blaha MJ, Chiuve SE, et al. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation. 2017;135(10):e146–e603. doi:10.1161/CIR.0000000000000485 - DOI - PMC - PubMed
    1. Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurol. 2009;8(8):741–754. doi:10.1016/S1474-4422(09)70150-4 - DOI - PubMed
    1. Lai S-M, Studenski S, Duncan PW, Perera S. Persisting Consequences of Stroke Measured by the Stroke Impact Scale. 2002. doi:10.1161/01.STR.0000019289.15440.F2 - DOI - PubMed
    1. Kwakkel G, Kollen BJ, van der Grond J, Prevo AJH. Probability of Regaining Dexterity in the Flaccid Upper Limb. Stroke. 2003;34(9):2181–2186. doi:10.1161/01.STR.0000087172.16305.CD - DOI - PubMed
    1. Broeks JG, Lankhorst GJ, Rumping K, Prevo AJ. The long-term outcome of arm function after stroke: results of a follow-up study. Disabil Rehabil. 1999;21(8):357–364. http://www.ncbi.nlm.nih.gov/pubmed/10503976. Accessed October 3, 2018. - PubMed

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