Virtual reality rehabilitation with functional electrical stimulation improves upper extremity function in patients with chronic stroke: a pilot randomized controlled study

How many fucking times does virtual reality need to be proven in research before someone writes up a fucking stroke protocol on it? NEVER I BET.
With 89 virtual reality posts back to September, 2011 it just shows the fucking incompetence in stroke. 
Ask your doctor what stroke research partner they are working with to determine the best interventions for stroke rehab. Your doctor can't be that lazy sit on your asses person, waiting for SOMEONE ELSE TO SOLVE THE PROBLEM. The solutions are out there we just need them translated into protocols.
http://www.archives-pmr.org/article/S0003-9993(18)30140-0/fulltext

Stephanie Hyeyoung Lee, MD

,

Ji-Yeong Lee

,

Mi-Young Kim

,

Yu-Jin Jeon

,

Suyoung Kim, MA

,

Joon-Ho Shin, MD, MSCorrespondence information about the author MD, MS Joon-Ho ShinEmail the author MD, MS Joon-Ho Shin

DOI: https://doi.org/10.1016/j.apmr.2018.01.030

Article Info

• Abstract

Abstract

Objective

To compare virtual reality (VR) combined with functional electrical stimulation (FES) to cyclic FES for improving upper extremity function and health-related quality of life in patients with a chronic stroke.

Design

A pilot, randomized, single blinded, controlled trial.

Setting

Stroke rehabilitation inpatient unit

Participants

Forty-eight participants with a hemiplegia secondary to a unilateral stroke for >3 months, with a hemiplegic wrist extensor Medical Research Council (MRC) scale score of 1–3.

Interventions

FES was applied to the wrist extensors and finger extensors. A virtual-reality(VR) based wearable rehabilitation device was used, combined with FES and virtual activity-based training. The control group received cyclic FES only. Both groups completed 20 sessions, over a 4-week period.

Main outcome measures

Primary outcomes were the change in the Fugl–Meyer Assessment: upper extremity (FMA) and Wolf Motor Function Test (WMFT) scores. Secondary outcomes were the change in the Box and Block test (BB), Jebsen Taylor Hand Function Test (JTT), and Stroke Impact Scale (SIS) scores. Assessments were performed at baseline (T0) and at 2 weeks (T1), 4 weeks (T4), and 8 weeks (T8). Between-group comparisons were evaluated using a repeated measures analysis of variance.

Results

Forty-one participants were included in the analysis. Compared to FES alone, VR-FES produced greater increase in FMA–distal score (p=0.011) and marginal improvement in JTT–gross score (p=0.057). VR-FES produced greater, although non-significant, improvements in all other outcome measures, except in the SIS–ADL/IADL score.

Conclusions

FES with VR-based rehabilitation may be more effective than cyclic FES to improve distal gross upper extremity function post-stroke.