Stroke
Conditions
Brief summary
Virtual reality training had already been used in stroke rehabilitation, and previous studies supported that it could improve upper extremity ability and increase motivation and pleasure than conventional methods. Pablo is a new VR game combined with motion sensor system which can detect subject's activities. Unlike commercial camera systems such as Kinect or XBOX, the systems require a continuous sightline or enough active range of motion which may increase risk of compensatory movement. Few of studies had investigated the rehabilitation effects on upper extremity with Pablo for patients with stroke.The purpose of this study is to investigate the effects of virtual reality upper extremity training through Pablo system in patients with chronic stroke.
Detailed description
PURPOSE: The purpose of this study is to investigate the effects of virtual reality upper extremity training through Pablo system in patients with chronic stroke. METHODS:Patients with mild to moderate motor deficits were recruited and randomly assigned to VR plus standard rehabilitation group(n=19), and standard rehabilitation group (n=19). After 12 training sessions (60 minutes a time, 2 times a week), the performance was assessed by a blinded assessor. The outcome measures included Fugl-Meyer Assessment-Upper Limb section(FMAUE), Box and block test(BBT), Dynanometer, active range of motion of shoulder and elbow,and Stroke Impact Scale.Modified Physical Activity Enjoyment Scale and adverse effect were recorded after each sessions.Collected data will be analyzed with sample T test by SPSS version 20.0, and alpha level was set at 0.05.
Interventions
BEHAVIORALvirtual reality game traning
The controllers were attached to upper extremity to control the game. The game could train the shoulder, elbow, and wrist control.
BEHAVIORALstandard treatment
The program included bilateral hand, grasp/release, and pinch activities.
Sponsors
Taipei Medical University Shuang Ho Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* First stroke with hemiplegia, * Chronicity of \>6 months * Could understand instructions * Brunnstrom stage of UE ≥IV.
Exclusion criteria
* Patients who were aged \<20 years and \>75 years * Patients with visual or auditory impairment who were unable to see or hear the feedback from the device clearly * Montreal Cognitive Assessment \<16 * Modified Ashworth Scale score of \>2 * Patients with other medical symptoms that can affect movement were excluded.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fugl-Meyer Assessment-upper extremity | Change from Baseline at 9 weeks | The Fugl-Meyer Assessment-upper extremity (FMA-UE) measures motor impairment in the upper extremity. The assessment consists of 33 items, including movement, reflex, grasp, and coordination, and a total score of 66. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Dynanometer | Change from Baseline at 9 weeks | The grip dynamometer was used to measure the maximum isometric strength of the hand and forearm muscles. The mean score of 3 trials was calculated. For this measurement, the elbow was placed at 90° and the forearm was placed in mid-position. |
| Active range of motion of shoulder and elbow | Change from Baseline at 9 weeks | The active range of motion of shoulder and elbow were measured through pablo system. |
| Box and block test | Change from Baseline at 9 weeks | The Box and block test (BBT) measures unilateral gross manual dexterity. The BBT score denotes the number of blocks transferred within 60 s. |
| Modified Physical Activity Enjoyment Scale | Every training session during 18 sessions, total sessions continued to 9 weeks | It is an scale that assesses enjoyment for physical activity by asking participants to rate how you feel at the moment about the physical activity you have been doing using a 7-point bipolar Likert scale, from 1 (I enjoy it) to 7 (I hate it). |
| Adverse effect times | Every training session during 18 sessions, total sessions continued to 9 weeks | To record the adverse effect times during the therapy. |
| Stroke Impact Scale | Change from Baseline at 9 weeks | The Stroke Impact Scale (SIS) is a quality of life measure designed specifically for patients with stroke. The instrument is a self-report questionnaire assessing eight domains: strength, hand function, activities of daily living (ADL)/instrumental ADL (IADL), mobility, communication, emotion, memory and thinking, and social participation. |
Countries
Taiwan
Outcome results
None listed