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Clinical Trial
. 2022 Oct 7;19(1):107.
doi: 10.1186/s12984-022-01086-4.

Feasibility and psychophysical effects of immersive virtual reality-based mirror therapy

Chris Heinrich  1 , Nadine Morkisch  2 , Tobias Langlotz  3 , Holger Regenbrecht  3 , Christian Dohle  2   4   5
Affiliations
Clinical Trial

Feasibility and psychophysical effects of immersive virtual reality-based mirror therapy

Chris Heinrich et al. J Neuroeng Rehabil. .

Abstract

Background: Virtual reality (VR) has been used as a technological medium to deliver mirror therapy interventions with people after stroke in numerous applications with promising results. The recent emergence of affordable, off-the-shelf head-mounted displays (like the Oculus Rift or HTC Vive) has opened the possibility for novel and cost-effective approaches for immersive mirror therapy interventions. We have developed one such system, ART-VR, which allows people after stroke to carry out a clinically-validated mirror therapy protocol in an immersive virtual environment and within a clinical setting.

Methods: A case cohort of 11 people with upper limb paresis following first time stroke at an in-patient rehabilitation facility received three interventions over a one week period. Participants carried out the BeST mirror therapy protocol using our immersive VR system as an adjunct therapy to their standard rehabilitation program. Our clinical feasibility study investigated intervention outcomes, virtual reality acceptance and user experience.

Results: The results show that the combination of an immersive VR system and mirror therapy protocol is feasible for clinical use. 9 out of 11 participants showed some improvement of their affected hand after the intervention. The vast majority of the participants (9/11) reported experiencing some psycho-physical effects, such as tingling or paraesthesia, in the affected limb during the intervention.

Conclusions: Our findings show that immersive VR-based mirror therapy is feasible and shows effects comparable to those of conventional mirror therapy. Trial Registration Trial was registered with the ISRCTN Registry (ISRCTN34011164) on December 3, 2021, retrospectively.

Keywords: Clinical feasibility; Mirror therapy; Stroke rehabilitation; Upper limb; User study; Virtual reality.

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Conflict of interest statement

Christian Dohle gives paid presentations and seminars on mirror therapy. Christian Dohle and Nadine Morkisch are authors of therapy manuals on Mirror Therapy, published at Schulz-Kirchner-Verlag (CD) and Hippocampus Verlag (CD and NM). The other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
People after stroke were asked to carry out a subset of the BeST-ART protocol with the unaffected hand while using the ART VR system. These hand exercises consisted of showing the numbers 1–5 with different modifications added (palm up/down, wrist extensions, arm extensions)
Fig. 2
Fig. 2
The ART VR system set up in a clinical setting which placed an emphasis on the user’s needs like a height-adjustable table, arm rest, and sanitation vr masks (and spray for the table)
Fig. 3
Fig. 3
The therapist used a handheld tablet computer to control the ART VR system which allowed them to position themselves as best fit to observe the user carrying out the hand exercises
Fig. 4
Fig. 4
The virtual environment that the person after stroke experiences (a) is kept minimal and non-distracting as possible to allow the user to focus their complete attention/gaze on the mirrored hand illusion (b)
Fig. 5
Fig. 5
CONSORT diagram detailing the participant flow in our clinical feasibility pilot study
See this image and copyright information in PMC

References

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