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Randomized Controlled Trial
. 2024 Sep 25:56:jrm36119.
doi: 10.2340/jrm.v56.36119.

Efficacy of a new video observational training method (intensive visual simulation) for motor recovery in the upper limb in subacute stroke: a feasibility and proof-of-concept study

Etienne Ojardias  1 , Ahmed Adham  1 , Hugo Bessaguet  2 , Virginie Phaner  3 , Diana Rimaud  2 , Pascal Giraux  4
Affiliations
Randomized Controlled Trial

Efficacy of a new video observational training method (intensive visual simulation) for motor recovery in the upper limb in subacute stroke: a feasibility and proof-of-concept study

Etienne Ojardias et al. J Rehabil Med. .

Abstract

Objective: To demonstrate the feasibility and efficacy of a new video-observation training method (intensive visual simulation) to improve upper limb function.

Design: Small sample, randomized, evaluator-blind, monocentric study.

Patients: Seventeen early subacute ischaemic stroke patients with complete hemiplegia were randomly assigned to the therapeutic group (n = 8) or control group (CG, n = 9).

Methods: Thirty sessions of intensive visual simulation combined with corrected visual feedback (therapeutic group) or uncorrected visual feedback (control group) were performed over 6 weeks on top of a standard rehabilitation programme.

Main outcome measure: 400-point hand assessment test (400p-HA).

Secondary outcome measures: Box and Blocks (B&B), Purdue Pegboard test, Minnesota.

Results: The 400p-HA test improved significantly from T0 to 6 months for both groups, with a significant difference between groups at 3 months (MW-UT p = 0.046) and 4 months (MW-UT p = 0.046) in favour of the therapeutic group. One-phase exponential modelling of 400p-HA showed a greater plateau for the therapeutic group (F test p = 0.0021). There was also faster recovery of the ability to perform the B&B tests for the therapeutic group (log-rank test p = 0.03).

Conclusion: This study demonstrated the feasibility and potential efficacy of an intensive visual simulation training programme to improve upper limb function in subacute stroke patients. A larger study is needed to confirm these results.

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Conflict of interest statement

Pascal Giraux is cofounder of the Dessintey Company. He was involved in designing the study and writing the manuscript. He was not involved in carrying out the patient intervention, patient assessment, or data analysis.

Figures

Fig. 1
Fig. 1
Stroke patient during practice on the IVS device.
Fig. 2
Fig. 2
Temporal evolution of the total 400p-HA test, expressed as percentage of recovery of the maximum score, for the therapeutic group (red dots) and the control group (blue dots); (a) mean difference with SD at fixed times: T0, END of intervention, M3, M4 and M6 poststroke. *p < 0.05 Mann–Whitney comparison; (b) one-phase exponential modelling for the therapeutic group (red dots and curve) and the control group (blue dots and curve).
Fig. 3
Fig. 3
Left column: temporal evolution for the 3 dexterity tests; right column: survival curves showing the % of participants recovering a non-0 score in the 3 dexterity tests.
See this image and copyright information in PMC

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