Use of client-centered virtual reality in rehabilitation after stroke: a feasibility study

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Use of client-centered virtual reality in rehabilitation after stroke: a feasibility study

Uso da realidade virtual centrada no cliente na reabilitação após acidente vascular encefálico: um estudo de viabilidade

Alberto Luiz Aramaki^{1  5} 
http://orcid.org/0000-0002-1740-6686

Rosana Ferreira Sampaio² 
http://orcid.org/0000-0002-4775-9650

Alessandra Cavalcanti^{3  4} 
http://orcid.org/0000-0002-2306-2031

Fabiana Caetano Martins Silva e Dutra^{1  3  5} 
http://orcid.org/0000-0003-3295-1583

¹Universidade Federal do Triângulo Mineiro, Programa de Pós-Graduação em Atenção à Saúde, Uberaba MG, Brasil;

²Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Ciências da Reabilitação, Belo Horizonte MG, Brasil;

³Universidade Federal do Triângulo Mineiro, Departamento de Terapia Ocupacional, Uberaba MG, Brasil;

⁴Universidade Federal do Triângulo Mineiro, Laboratório Integrado de Tecnologia Assistiva (LITA), Uberaba MG, Brasil;

⁵Universidade Federal do Triângulo Mineiro, Núcleo de Estudos e Pesquisas em Trabalho, Participação Social e Saúde (NETRAS), Uberaba MG, Brasil.

ABSTRACT

Patient-centered virtual reality (VR) programs could assist in the functional recovery of people after a stroke.

Objectives:

To analyze the feasibility of a rehabilitation protocol using client-centered VR and to evaluate changes in occupational performance and social participation.

Methods:

This was a mixed methods study. Ten subacute and chronic stroke patients participated in the rehabilitation program using games in non-immersive VR for 40 minutes/day, three days/week, for 12 weeks. Sociodemographic information was collected and the outcome variables included were the Canadian Occupational Performance Measure (COPM) and the Participation Scale. A field diary was used to record the frequency of attendance and adherence of participants and an interview was conducted at the end of program.

Results:

There were significant and clinically-relevant statistical improvements in the COPM performance score (p < 0.001; CI = 1.29 − 4.858) and in the COPM satisfaction score (p < 0.001; CI = 1.37 − 5.124), with a difference greater than 4.28 points for performance and 4.58 points for satisfaction. The change in the scores for participation was statistically significant (p = 0.046), but there was no clinical improvement (d_cohen = −0.596, CI = −1.862 − 0.671). The majority of participants reported more than 75% consecutive attendance of sessions and there was 100% adherence to the program. In the interviews, the participants described their post-stroke difficulties; how the video game motivated their engagement in rehabilitation; and the improvement of occupational performance and social participation after participating in the program.

Conclusions:

VR is a viable tool for the rehabilitation of stroke patients with functional gains, mainly regarding occupational performance and performance satisfaction.(But you specifically said there was no clinical improvement.)