scholarly journals Effectiveness of the Virtual Reality System Toyra on Upper Limb Function in People with Tetraplegia: A Pilot Randomized Clinical Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
I. Dimbwadyo-Terrer ◽  
A. Gil-Agudo ◽  
A. Segura-Fragoso ◽  
A. de los Reyes-Guzmán ◽  
F. Trincado-Alonso ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Upper Limb ◽  
Conventional Therapy ◽  
Control Group ◽  
Virtual Reality System ◽  
Limb Function ◽  
Upper Limb Function ◽  
Level Of Satisfaction ◽  
High Level

The aim of this study was to investigate the effects of a virtual reality program combined with conventional therapy in upper limb function in people with tetraplegia and to provide data about patients’ satisfaction with the virtual reality system. Thirty-one people with subacute complete cervical tetraplegia participated in the study. Experimental group received 15 sessions with Toyra®virtual reality system for 5 weeks, 30 minutes/day, 3 days/week in addition to conventional therapy, while control group only received conventional therapy. All patients were assessed at baseline, after intervention, and at three-month follow-up with a battery of clinical, functional, and satisfaction scales. Control group showed significant improvements in the manual muscle test (p= 0,043, partialη2= 0,22) in the follow-up evaluation. Both groups demonstrated clinical, but nonsignificant, changes to their arm function in 4 of the 5 scales used. All patients showed a high level of satisfaction with the virtual reality system. This study showed that virtual reality added to conventional therapy produces similar results in upper limb function compared to only conventional therapy. Moreover, the gaming aspects incorporated in conventional rehabilitation appear to produce high motivation during execution of the assigned tasks. This trial is registered with EudraCT number2015-002157-35.

scholarly journals The effect of virtual reality on motor anticipation and hand function in patients with subacute stroke: A randomised trial on movement-related potential.

2020 ◽  
Author(s):  
Ling Chen ◽  
Yi Chen ◽  
Wai Leung Ambrose Lo
Keyword(s):  
Virtual Reality ◽  
Reaction Time ◽  
Upper Limb ◽  
Cortical Excitability ◽  
Control Group ◽  
Post Intervention ◽  
Limb Function ◽  
Upper Limb Function ◽  
Subacute Stroke ◽  
Vr Training

Abstract Background: Impaired cognitive ability to anticipate the required control may affect functional recovery. The cortical excitability of task related motor anticipation for upper limb movement induced by virtual reality (VR) training is unknown. Aims: To investigate the changes of motor anticipation, cortical excitability and upper limb function induced by VR training in subacute stroke survivors. Methods: Upper limb hemiparesis resulting from the first occurrence of stroke within 1 to 6 months were recruited. Participants were randomly allocated to conventional therapy or VR intervention. Electroencephalogram (EEG) and electromyography (EMG) were simultaneously recorded during palmar grasp motion. Outcome measures of contingent negative variation (CNV) latency, mean peak amplitude, electromyography (EMG) reaction time, Upper Limb Fugl-Meyer Assessment (UL-FMA) and the Action Research Arm Test (ARAT) were recorded pre and post intervention. The EEG and EMG differences between the two groups were assessed by mixed model ANOVA (p=0.05). The differences in UL-FMA and ARAT were assessed Wilcoxon signed-rank test (p=0.05). Results: The reduction in EMG reaction time difference, CNV latency and mean peak amplitude were significantly lower in the VR group than the control group when executing movement with the paretic hand. ARAT and UL-FMA scores were significantly higher in the VR group than the control group post intervention. Conclusions: The findings indicated a reduction in brain computational demand during palmar grasp task. Improvements in clinical function in the VR group suggested that VR intervention may be more beneficial in improving upper limb function patients with subacute stroke. Improvement in upper limb function may be related to improvement of the neural anticipatory process. Trial registration: Chinese Clinical Trial Registry (Registration No.: ChiCTR-IOC-15006064). Registered on 11 May 2015. Retrospectively registered. http://www.chictr.org.cn/searchprojen.aspx

scholarly journals Virtual Reality Games as an Adjunct in Improving Upper Limb Function and General Health among Stroke Survivors

2019 ◽  
Vol 16 (24) ◽  
pp. 5144 ◽  
Author(s):  
Mohd Azzuan Ahmad ◽  
Devinder Kaur Ajit Singh ◽  
Nor Azlin Mohd Nordin ◽  
Khor Hooi Nee ◽  
Norliza Ibrahim
Keyword(s):  
Virtual Reality ◽  
Outcome Measures ◽  
Upper Limb ◽  
General Health ◽  
Sensory Function ◽  
Control Group ◽  
Stroke Survivors ◽  
Limb Function ◽  
Significant Time ◽  
Upper Limb Function

Virtual reality (VR) games has the potential to improve patient outcomes in stroke rehabilitation. However, there is limited information on VR games as an adjunct to standard physiotherapy in improving upper limb function. This study involved 36 participants in both experimental (n = 18) and control (n = 18) groups with a mean age (SD) of 57 (8.20) and 63 (10.54) years, respectively. Outcome measures were the Fugl-Meyer assessment for upper extremities (FMA-UE), Wolf motor function test (WMFT), intrinsic motivation inventory (IMI), Lawton of instrumental activities of daily living (IADL), and stroke impact scale (SIS) assessed at pre-post intervention. The experimental group had 0.5 h of upper limb (UL) VR games with 1.5 h of standard physiotherapy, and the control group received 2 h of standard physiotherapy. The intervention for both groups was performed once a week for eight consecutive weeks. The results showed a significant time–group interaction effect for IMI (p = 0.001), Lawton IADL (p = 0.01) and SIS domain of communication (p = 0.03). A significant time effect was found in FMA-UE (p = 0.001), WMFT (p = 0.001), Lawton IADL (p = 0.01), and SIS domains; strength, ADL and stroke recovery (p < 0.05). These results indicated an improvement in UL motor ability, sensory function, instrumental ADL, and quality of life in both groups after eight weeks of intervention. However, no significant (p > 0.05) group effect on all the outcome measures was demonstrated. Thus, replacing a portion of standard physiotherapy time with VR games was equally effective in improving UL function and general health compared to receiving only standard physiotherapy among stroke survivors.

scholarly journals EFFICACY OF USING VIRTUAL REALITY IN POST-STROKE UPPER LIMB PARESIS

2018 ◽  
Vol 35 (1) ◽  
pp. 60-67 ◽  
Author(s):  
M V Dolganov ◽  
M I Karpova
Keyword(s):  
Virtual Reality ◽  
Upper Limb ◽  
Standard Therapy ◽  
Main Group ◽  
Control Group ◽  
Limb Function ◽  
Acute Period ◽  
Training Course ◽  
Assessment Scores ◽  
Upper Limb Function

Aim. To estimate the efficacy of using training by means of virtual reality in restoration of the upper limb function in patients during the acute period of stroke. Materials and methods. 48 patients in the acute period of stroke (average time from the onset of stroke 4.5 ± 1.3 days, mean age 67 (45; 72.1) years were randomized into 2 groups: the main group (standard therapy + virtual reality) and the control (standard therapy alone). Patients of the main group underwent a course of virtual reality training, lasting for 15 minutes, twice a day for 10 days. The functional status before the onset of training course and after it was evaluated using Fugl-Meyer Assessment Scores (FMA), Motor Assessment Scale (MAS), Ashworth Scale, Modified Barthel Index Score (MBI), Action Research Arm Test (ARAT), 9-Hole Peg Test, Rankin Scale, Function Independence Measure (FIM) and dynamometry. Results. When assessing FMA of “upper limb” ( p = 0.029), “wrist” ( p = 0.04), “hand speed” ( p = 0.02); MAS ( p = 0.042), 9-Hole Peg Test ( p = 0.028), paretic hand dynamometry ( p = 0.03) and FIM ( p = 0.045), patients of the main group demonstrated statistically significant improvement versus the control group. Conclusions. The results detected that inclusion of a short training course, using virtual reality, improves the upper limb function in patients during the acute period of stroke.

Virtual reality on motor anticipation and hand function in patients with subacute stroke : A study on movement-related potential.

2020 ◽  
Author(s):  
Ling Chen ◽  
Yi Chen ◽  
Wai Leung Ambrose Lo
Keyword(s):  
Virtual Reality ◽  
Reaction Time ◽  
Upper Limb ◽  
Cortical Excitability ◽  
Control Group ◽  
Post Intervention ◽  
Limb Function ◽  
Upper Limb Function ◽  
Subacute Stroke ◽  
Vr Training

Abstract Background: Impaired cognitive ability to anticipate the required control may affect functional recovery. The cortical excitability of task related motor anticipation for upper limb movement induced by virtual reality (VR) training is unknown. Aims: To investigate the changes of motor anticipation, cortical excitability and upper limb function induced by VR training in subacute stroke survivors.Methods: Upper limb hemiparesis resulting from the first occurrence of stroke within 1 to 6 months were recruited. Participants were randomly allocated to conventional therapy or VR intervention. Electroencephalogram (EEG) and electromyography (EMG) were simultaneously recorded during parlmar grasp motion. Outcome measures of contingent negative variation (CNV) latency, mean peak amplitude, electromyography (EMG) reaction time, Upper Limb Fugl-Meyer Assessment (UL-FMA) and the Action Research Arm Test (ARAT) were recorded pre and post intervention. The EEG and EMG differences between the two groups were assessed by mixed model ANOVA (p=0.05). The differences in UL-FMA and ARAT were assessed Wilcoxon signed-rank test (p=0.05). Results: The reduction in EMG reaction time difference, CNV latency and mean peak amplitude were significantly lower in the VR group than the control group when executing movement with the paretic hand. ARAT and UL-FMA scores were significantly higher in the VR group than the control group post intervention. Conclusions: The findings indicated a reduction in brain computational demand during palmar grasp task. Improvements in clinical function in the VR group suggested that VR intervention may be more beneficial in improving upper limb function patients with subacute stroke. Improvement in upper limb function may be related to improvement of the neural anticipatory process.

scholarly journals Effects of virtual reality therapy on upper limb function after stroke and the role of neuroimaging as a predictor of a better response

2018 ◽  
Vol 76 (10) ◽  
pp. 654-662 ◽  
Author(s):  
Maicon Gabriel Gonçalves ◽  
Mariana Floriano Luiza Piva ◽  
Carlos Leonardo Sacomani Marques ◽  
Rafael Dalle Molle da Costa ◽  
Rodrigo Bazan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Virtual Reality ◽  
Upper Limb ◽  
Internal Capsule ◽  
Functional Independence ◽  
Reality Therapy ◽  
Limb Function ◽  
Virtual Reality Therapy ◽  
Upper Limb Function

ABSTRACT Background: Virtual reality therapy (VRT) is an interactive intervention that induces neuroplasticity. The aim was to evaluate the effects of VRT associated with conventional rehabilitation for an upper limb after stroke, and the neuroimaging predictors of a better response to VRT. Methods: Patients with stroke were selected, and clinical neurological, upper limb function, and quality of life were evaluated. Statistical analysis was performed using a linear model comparing pre- and post-VRT. Lesions were segmented in the post-stroke computed tomography. A voxel-based lesion-symptom mapping approach was used to investigate the relationship between the lesion and upper limb function. Results: Eighteen patients were studied (55.5 ± 13.9 years of age). Quality of life, functional independence, and dexterity of the upper limb showed improvement after VRT (p < 0.001). Neuroimaging analysis showed negative correlations between the internal capsule lesion and functional recovery. Conclusion: VRT showed benefits for patients with stroke, but when there was an internal capsule lesion, a worse response was observed.

scholarly journals Effectiveness of ultrasound guided ethanol motor points block in reduction of spasticity and improvement of upper limb function in hemiplegic patients: a randomized controlled study

2020 ◽  
Vol 7 (9) ◽  
pp. 1409
Author(s):  
Sreejith C. ◽  
Akoijam Joy Singh ◽  
Longjam Nilachandra Singh ◽  
Kanti Rajkumari ◽  
Margaret Chabungbam ◽  
...  
Keyword(s):  
Upper Limb ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Control Group ◽  
Ultrasound Guided ◽  
Limb Function ◽  
Ethanol Injection ◽  
Randomized Controlled ◽  
Upper Limb Function ◽  
Group A

Background: Stroke is the third leading cause of disability in general population commonly causing upper motor neuron syndrome complications like spasticity, which is more common in upper limb. Ethanol injection into spastic muscle is an emerging effective treatment in the spasticity management. Ethanol causes selective destruction of nerve fibers through denaturation of protein.Methods: A randomized controlled study was conducted for a period of 2 years from March 2018 on sixty-eight hemiplegic patients to assess the effectiveness of ethanol muscle block in reduction of spasticity and improvement in functional ability. The patients were allocated into two groups (Group A and B). Group A received ultrasound guided intramuscular ethanol injection along with range of motion (ROM) exercises and wrist hand orthosis (WHO) and Group B received ROM exercises and WHO. The outcomes were measured by modified ashworth scale (MAS) for spasticity and modified version of motor assessment scale for functional improvement.Results: Intervention group showed significant improvement in spasticity shown by reduction of MAS of elbow flexors from 3 at baseline to 1.15±0.3 at 12 weeks as compared to control group with 3 at baseline to 1.76±0.5 at 12 weeks (p<0.05). Upper limb function scale of study group improved from 1.5±0.8 to 3.0±0.6 at 12 weeks compared to control group 1.3±0.8 to 2.8±0.6 (p<0.05).Conclusions: It can thus be concluded that intramuscular injection of ethanol accompanied by wrist hand orthosis have beneficial effect on improvement of spasticity and upper limb function.

scholarly journals Effect of Self-care Training on Upper Limb Function and Pain After Breast Cancer Surgery

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Somyye Noura ◽  
Fatemeh Kiani ◽  
Nezarali Moulaei ◽  
Mojtaba Tasbandi ◽  
Ebrahim Ebrahimi Tabas
Keyword(s):  
Breast Cancer ◽  
Upper Limb ◽  
Intervention Group ◽  
Self Care ◽  
Control Group ◽  
Limb Function ◽  
Upper Limb Function ◽  
Care Training ◽  
The Mean ◽  
And Control

Background: Breast cancer patients who undergo mastectomy encounter numerous problems, the most annoying of which is lymphedema followed by pain and decreased function in the affected limb. Objectives: This study examined the effect of self-care training on upper limb function and pain after breast surgery. Methods: This quasi-experimental study was performed on two groups of 60 patients with breast cancer in the Oncology Ward of Zahedan University of Medical Sciences in 2021. The patients were selected based on the inclusion criteria and through convenience sampling and were then randomly divided into intervention and control groups. The patients in the intervention group attended self-care training and exercise programs implemented in five sessions in addition to the routine care. One and three months after the intervention, upper limb function and pain were measured with DASH and McGill pain questionnaires. The repeated measures analysis of variance (ANOVA) and Bonferroni test were used to compare the pre-, and post-intervention mean scores and mean differences in the two groups. Results: The mean scores of upper limb function one and three months after the training program in the intervention group were lower than the mean scores of the control group. In other words, the quality of upper limb function was not significantly different despite the changes in the first month, but upper limb function significantly improved three months after the intervention (P < 0.001 vs. P = 0.06). The mean pain scores before, one month, and three months after the intervention in the intervention group were 10.4, 35.7, and 6.26, respectively, and the corresponding values in the control group were 10.8, 41.7, and 21.1, respectively, showing significant differences between the two groups, with the intervention group having lower pain scores than the control group (P = 0.001). Conclusions: Since lymphedema and its consequences, including decreased upper limb function and pain, are very serious issues, medical staff can give priority to this training program and implement it to prevent and control these complications.

scholarly journals Effect of Immersive Virtual Reality-Based Bilateral Arm Training in Patients with Chronic Stroke

2021 ◽  
Vol 11 (8) ◽  
pp. 1032
Author(s):  
Yo-Han Song ◽  
Hyun-Min Lee
Keyword(s):  
Virtual Reality ◽  
Upper Limb ◽  
Chronic Stroke ◽  
Limb Function ◽  
Upper Limb Rehabilitation ◽  
Upper Limb Function ◽  
Artificial Environment ◽  
Beta Power ◽  
Significant Difference ◽  
Bilateral Arm Training

Virtual reality (VR)-based therapies are widely used in stroke rehabilitation. Although various studies have used VR techniques for bilateral upper limb training, most have been only semi-immersive and have only been performed in an artificial environment. This study developed VR content and protocols based on activities of daily living to provide immersive VR-based bilateral arm training (VRBAT) for upper limb rehabilitation in stroke patients. Twelve patients with chronic stroke were randomized to a VRBAT group or a normal bilateral arm training (NBAT) group and attended 30-min training sessions five times a week for four weeks. At the end of the training, there was a significant difference in upper limb function in both groups (p < 0.05) and in the upper limb function sensory test for proprioception in the NBAT group (p < 0.05). There was no significant between-group difference in upper limb muscle activity after training. The relative alpha and beta power values for electroencephalographic measurements were significantly improved in both groups. These findings indicate that both VRBAT and NBAT are effective interventions for improving upper limb function and electroencephalographic activity in patients with chronic stroke.

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