Deans' stroke musings: Virtual reality for upper extremity rehabilitation in early stroke: a pilot randomized controlled trial

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, October 16, 2014

Virtual reality for upper extremity rehabilitation in early stroke: a pilot randomized controlled trial

I wish they would just take all these damned studies on virtual reality and just make a stroke protocol out of it. Stop studying it and deliver some results! That is what a great stroke association would do instead of just putting out press releases.
http://cre.sagepub.com/content/28/11/1107.abstract?

¹Allied Health Division, Department of Occupational Therapy, Singapore General Hospital, Singapore
²Division of Medicine, Department of Rehabilitation Medicine, Singapore General Hospital, Singapore
³Allied Health Division, Department of Physiotherapy, Singapore General Hospital, Singapore
⁴Division of Research, Health Services Research and Biostatistics, Centre for Quantitative Medicine, Duke-NUS, Singapore General Hospital, Singapore

Chan Wai Yin, Department of Occupational Therapy, Singapore General Hospital, Rehabilitation Center, Block 1 Level 1, Outram Road, 169608, Singapore. Email: yetta.chan.w.y@sgh.com.sg

Abstract

Objectives: To investigate the effect of virtual reality (VR) rehabilitation on upper extremity motor performance of patients with early stroke.

Design: Pilot randomized controlled trial.

Setting: Rehabilitation wards.

Participants: Twenty three adults with stroke (mean age (SD) = 58.35 (13.45) years and mean time since stroke (SD) = 16.30 (7.44) days).

Interventions: Participants were randomly assigned to VR group (n=11) or control group (n=12). VR group received nine 30 minutes upper extremity VR therapy in standing (five weekdays in two weeks) plus conventional therapy, which included physical and occupational therapy. Control group received only conventional therapy, which was comparable to total training time received by VR group (mean training hours (SD):VR = 17.07 (2.86); control = 15.50 (2.79)).

Main outcome measures: The main outcome measure was the Fugl-Meyer Assessment (FMA). Secondary outcomes included Action Research Arm Test, Motor Activity Log and Functional Independence Measure. Results were taken at baseline, post intervention and 1-month post intervention. Participants’ feedback and adverse effects were recorded.

Results: All participants improved in FMA scores (mean change (SD) = 11.65 (8.56), P<.001). These effects were sustained at one month after intervention (mean (SD) change from baseline = 18.67 (13.26), P<.001). All other outcome measures showed similar patterns. There were no significant differences in improvement between both groups. Majority of the participants found VR training useful and enjoyable, with no serious adverse effects reported.

Conclusion: Although additional VR training was not superior to conventional therapy alone, this study demonstrates the feasibility of VR training in early stroke.