Effects of task-specific virtual reality training using a Leap Motion Controller on hemiparetic upper extremity in patients with stroke
Abstract Background: Task-specific training has been proven to be effective in promoting recovery of the hemiparetic upper extremities after a stroke. This study was to develop a new and innovative task-specific VR (TS-VR) program using a Leap Motion Controller VR device and the Unity3D program for distal hand function training, and to investigate whether a two-week program of TS-VR training would promote recovery of the hemiparetic upper extremity in patients with chronic stroke.Methods: We designed the TS-VR program based on seven general hand function tasks used in the activities of daily living that require upper limb movement, such as pushing open a door and pouring water. Then, we examined the content validity of the TS-VR according to the views of an expert panel and through field testing on patients with stroke. The final version of the TS-VR was tested on 20 patients suffering from chronic stroke with upper extremity hemiparesis over 2 weeks, 5 sessions per week, 30 minutes per session. Outcomes were assessed using the Fugl-Meyer Assessment-Upper Extremity score (FMA-UE), the Wolf Motor Function Test (WMFT), and the Motor Activity Log (MAL). Data were collected at the first session (week 0), last session (week 2), and follow-up session (week 5). Patients’ arm impairments were stratified into lower- and higher-functioning groups according to the Functional Test for the Hemiplegic Upper Extremity (FTHUE).Results: Significant improvements in upper extremity functions were found after TS-VR training in FMA-UE Total score (χ2=34.219, p=0.000), FMA-UL subscore (χ2=31.2, p=0.000), FMA-Hand subscore (χ2=22.6, p=0.000), and WFMT score (χ2=27.8, p=0.000) among the three time occasions, but no significant effect on grip strength was found. Moreover, the higher-functioning group (levels 5-7 in FTHUE) benefited more from the TS-VR, as indicated in outcome measures of FMA-UL, FMA-Hand, FMA-UE Total, and WMFT respectively, as well as amount of use score in MAL, but this was not the case for those in the lower-functioning group (levels 1-4 in FTHUE).Conclusions: Our findings suggest that our new TS-VR training system was useful for upper extremity recovery in patients with chronic stroke. It has potential to be applied in clinical settings in future.
