Effects of virtual reality-based motor control training on inflammation, oxidative stress, neuroplasticity and upper limb motor function in patients with chronic stroke: a randomized controlled trial

Abstract Background Immersive virtual reality (VR)-based motor control training (VRT) is an innovative approach to improve motor function in patients with stroke. Currently, outcome measures for immersive VRT mainly focus on motor function. However, serum biomarkers help detect precise and subtle physiological changes. Therefore, this study aimed to identify the effects of immersive VRT on inflammation, oxidative stress, neuroplasticity and upper limb motor function in stroke patients. Methods Thirty patients with chronic stroke were randomized to the VRT or conventional occupational therapy (COT) groups. Serum biomarkers including interleukin 6 (IL-6), intracellular adhesion molecule 1 (ICAM-1), heme oxygenase 1 (HO-1), 8-hydroxy-2-deoxyguanosine (8-OHdG), and brain-derived neurotrophic factor (BDNF) were assessed to reflect inflammation, oxidative stress and neuroplasticity. Clinical assessments including active range of motion of the upper limb and the Fugl-Meyer Assessment for upper extremity (FMA-UE) were also used. Two-way mixed analyses of variance (ANOVAs) were used to examine the effects of the intervention (VRT and COT) and time on serum biomarkers and upper limb motor function. Results We found significant time effects in serum IL-6 (p = 0.010), HO-1 (p = 0.002), 8-OHdG (p = 0.045), and all items/subscales of the clinical assessments (ps < 0.05), except FMA-UE-Coordination/Speed (p = 0.055). However, significant group effects existed only in items of the AROM-Elbow Extension (p = 0.007) and AROM-Forearm Pronation (p = 0.048). Moreover, significant interactions between time and group existed in item/subscales of FMA-UE-Shoulder/Elbow/Forearm (p = 0.004), FMA-UE-Total score (p = 0.008), and AROM-Shoulder Flexion (p = 0.001). Conclusion This was the first study to combine the effectiveness of immersive VRT using serum biomarkers as outcome measures. Our study demonstrated promising results that support the further application of commercial and immersive VR technologies in patients with chronic stroke.

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Effects of Virtual Reality-based Motor Control Training on Inflammation, Oxidative Stress and Neuroplasticity in Patients with Chronic Stroke: A Randomized Controlled Trial

10.21203/rs.3.pex-1594/v1 ◽

2021 ◽

Author(s):

Chien-Yu Huang ◽

Wei-Chi Chiang ◽

Ya-Chin Yeh ◽

Shih-Chen Fan ◽

Wan-Hsien Yang ◽

...

Keyword(s):

Oxidative Stress ◽

Virtual Reality ◽

Motor Control ◽

Upper Limb ◽

Motor Performance ◽

Controlled Trial ◽

Controlled Study ◽

Heme Oxygenase 1 ◽

Randomized Controlled ◽

Vr Training

Abstract Background: Virtual reality (VR)-based rehabilitation is the innovative approach in motor control training in individuals with stroke. Currently, most outcome assessments of motor performance in stroke were based on subjective functional scales and instruments. Detecting serum biomarkers related to inflammation, oxidative stress and neuroplasticity, might provide precise and subtle changes after motor control training in patients with stroke.Objectives: This study aims to identify the effects of immersive VR-based intervention of motor control training on motor function improvement, inflammation, oxidative stress and neuroplasticity in patients with stroke.Methods: This is an assessor-blinded, randomized controlled study. Patients with stroke will be randomly assigned to VR training (VRT) group or the conventional occupational therapy (COT) group. Clinical assessments will include motor performance and active range of motion (AROM) of the upper limb. Serum concentrations of inflammation, oxidative stress and neuroplasticity will be assessed, including interleukin 6 (IL-6), intracellular adhesion molecule 1 (ICAM-1), heme oxygenase 1 (HO-1), 8-hydroxy-2-deoxyguanosine (8-OHdG), and brain-derived neurotrophic factor (BDNF).Expected outcomes: After the intervention, both groups will show improvements in motor performance and the changes of inflammation, oxidative stress and neuroplasticity. As compared to the COT group, the VRT group will show greater improvements in motor performance and AROM of the upper limb, greater induction of HO-1 and BDNF levels, and greater reductions in 8-OHdG.The trial registration number for this study is ChiCTR2100047853.

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Intensive virtual reality-based training for upper limb motor function in chronic stroke: a feasibility study using a single case experimental design and fMRI

Disability and Rehabilitation Assistive Technology ◽

10.3109/17483107.2014.908963 ◽

2014 ◽

Vol 10 (5) ◽

pp. 385-392 ◽

Cited By ~ 14

Author(s):

Corina Schuster-Amft ◽

Andrea Henneke ◽

Birgit Hartog-Keisker ◽

Lisa Holper ◽

Ewa Siekierka ◽

...

Keyword(s):

Virtual Reality ◽

Experimental Design ◽

Motor Function ◽

Feasibility Study ◽

Upper Limb ◽

Single Case ◽

Chronic Stroke

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Tools and Techniques Used With Robotic Devices to Quantify Upper-Limb Function in Typically Developing Children: A Systematic Review

Rehabilitation Process and Outcome ◽

10.1177/1179572720979013 ◽

2020 ◽

Vol 9 ◽

pp. 117957272097901

Author(s):

Stephan CD Dobri ◽

Hana M Ready ◽

Theresa Claire Davies

Keyword(s):

Systematic Review ◽

Outcome Measures ◽

Motor Function ◽

Upper Limb ◽

Rate Of Change ◽

Typically Developing ◽

Typically Developing Children ◽

Upper Limb Function ◽

Robotic Devices ◽

Tools And Techniques

Background: Robotic devices have been used to quantify function, identify impairment, and rehabilitate motor function extensively in adults, but less-so in younger populations. The ability to perform motor actions improves as children grow. It is important to quantify this rate of change of the neurotypical population before attempting to identify impairment and target rehabilitation techniques. Objectives: For a population of typically developing children, this systematic review identifies and analyzes tools and techniques used with robotic devices to quantify upper-limb motor function. Since most of the papers also used robotic devices to compare function of neurotypical to pathological populations, a secondary objective was introduced to relate clinical outcome measures to identified robotic tools and techniques. Methods: Five databases were searched between February 2019 and August 2020, and 226 articles were found, 19 of which are included in the review. Results: Robotic devices, tasks, outcome measures, and clinical assessments were not consistent among studies from different settings but were consistent within laboratory groups. Fifteen of the 19 articles evaluated both typically developing and pathological populations. Conclusion: To optimize universally comparable outcomes in future work, it is recommended that a standard set of tasks and measures is used to assess upper-limb motor function. Standardized tasks and measures will facilitate effective rehabilitation.

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Early post-stroke rehabilitation for upper limb motor function using virtual reality and exoskeleton: equally efficient in older patients

Neurologia i Neurochirurgia Polska ◽

10.5603/pjnns.a2020.0096 ◽

2020 ◽

Author(s):

Tereza Gueye ◽

Miriama Dedkova ◽

Vladimir Rogalewicz ◽

Marcela Grunerova-Lippertova ◽

Yvona Angerova

Keyword(s):

Virtual Reality ◽

Motor Function ◽

Upper Limb ◽

Older Patients ◽

Stroke Rehabilitation ◽

Post Stroke

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Combined Transcranial Direct Current Stimulation and Virtual Reality-Based Paradigm for Upper Limb Rehabilitation in Individuals with Restricted Movements. A Feasibility Study with a Chronic Stroke Survivor with Severe Hemiparesis

Journal of Medical Systems ◽

10.1007/s10916-018-0949-y ◽

2018 ◽

Vol 42 (5) ◽

Cited By ~ 7

Author(s):

María Antonia Fuentes ◽

Adrián Borrego ◽

Jorge Latorre ◽

Carolina Colomer ◽

Mariano Alcañiz ◽

...

Keyword(s):

Virtual Reality ◽

Feasibility Study ◽

Upper Limb ◽

Direct Current ◽

Transcranial Direct Current Stimulation ◽

Stroke Survivor ◽

Chronic Stroke ◽

Upper Limb Rehabilitation ◽

Direct Current Stimulation ◽

Limb Rehabilitation

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Virtual Reality effect on upper limb Motor function paretic in post stroke

Revista Neurociências ◽

10.4181/rnc.2015.23.04.1038.06p ◽

2015 ◽

Vol 23 (04) ◽

pp. 493-498 ◽

Cited By ~ 3

Author(s):

Maria Luiza Galvão ◽

Príscila Gouvêa ◽

Gabriela Ocamoto ◽

Adriana Silva ◽

Luciana Reis ◽

...

Keyword(s):

Virtual Reality ◽

Motor Function ◽

Upper Limb ◽

Post Stroke ◽

Reality Effect

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The effects of anxiety and dual-task on upper limb motor control of chronic stroke survivors

Scientific Reports ◽

10.1038/s41598-020-71845-7 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Mahnaz Hejazi-Shirmard ◽

Laleh Lajevardi ◽

Mehdi Rassafiani ◽

Ghorban Taghizadeh

Keyword(s):

Motor Control ◽

Upper Limb ◽

Dual Task ◽

Chronic Stroke ◽

Stroke Survivors ◽

High Anxiety ◽

Reach And Grasp ◽

Stroke Group ◽

Task Conditions ◽

Hand Opening

Abstract This study was designed to investigate the effects of anxiety and dual-task on reach and grasp motor control in chronic stroke survivors compared with age- and sex-matched healthy subjects (HC). Reach and grasp kinematic data of 68 participants (high-anxiety stroke (HA-stroke), n = 17; low-anxiety stroke (LA-stroke), n = 17; low-anxiety HC, n = 17; and high-anxiety HC, n = 17) were recorded under single- and dual-task conditions. Inefficient reach and grasp of stroke participants, especially HA-stroke were found compared with the control groups under single- and dual-task conditions as evidenced by longer movement time (MT), lower and earlier peak velocity (PV) as well as delayed and smaller hand opening. The effects of dual-task on reach and grasp kinematic measures were similar between HCs and stroke participants (i.e., increased MT, decreased PV that occurred earlier, and delayed and decreased hand opening), with greater effect in stroke groups than HCs, and in HA-stroke group than LA-stroke group. The results indicate that performing a well-learned upper limb movement with concurrent cognitive task leads to decreased efficiency of motor control in chronic stroke survivors compared with HCs. HA-stroke participants were more adversely affected by challenging dual-task conditions, underlying importance of assessing anxiety and designing effective interventions for it in chronic stroke survivors.

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