Non-immersive virtual reality for upper limb motor function after chronic stroke
Photo by Bermix Studio / Unsplash
Key Takeaway
Consider that non-immersive virtual reality may improve upper limb function after chronic stroke, but evidence is limited by small sample and non-significant results.
This randomized controlled trial enrolled 26 patients with chronic middle cerebral artery ischemic stroke, with a final sample of 21 patients (9 in the non-immersive virtual reality group, 12 in the conventional occupational therapy group). The intervention was a non-immersive virtual reality program (MindMotion GO) compared to conventional occupational therapy over an 8-week period.
The primary outcome was upper limb motor function measured by the FuglMeyer Assessment Upper Extremity (FMAUE). The non-immersive virtual reality group had a median improvement of 21, while the control group had a median improvement of 2.50. However, the between-group differences were not statistically significant (P > 0.05).
Secondary outcomes included quality of life, emotional status, and caregiver burden. No significant changes were observed for these measures. Safety was not formally reported, but the intervention was described as safe, and five participants were lost to follow up.
Key limitations include the small sample size, lack of statistical significance between groups, and loss to follow up. The practice relevance suggests support for incorporating accessible, task-oriented virtual rehabilitation in long-term stroke care, but the evidence is preliminary.
View Original Abstract ↓
Background: Functional recovery after chronic stroke remains limited, requiring intensive and engaging rehabilitation approaches. Non immersive virtual reality (NIVR) provides taskoriented, feedback driven training that may enhance motor recovery in this population. Objective: To evaluate the clinical effectiveness of a NIVR based intervention (MindMotion GO) on upper limb motor function in patients with chronic left middle cerebral artery ischaemic stroke (LMCA stroke). Methods: A single blind randomized controlled trial was conducted in 26 patients with chronic middle cerebral artery stroke. Five participants were lost to follow up, resulting in a final sample of 21 patients allocated to the nonimmersive virtual reality group (NIVR, n = 9) and conventional occupational therapy group (n = 12). Both groups completed an 8 week intervention consisting of two 30 minute sessions per week. The primary outcome was upper limb motor function assessed using the FuglMeyer Assessment Upper Extremity (FMAUE). Secondary outcomes included health related quality of life (SF12v2), emotional status (Hospital Anxiety and Depression Scale), and caregiver burden (Zarit Burden Interview). Statistical analyses were performed using the intention to treat principle with non parametric tests. Results: The NIVR group showed a clinically meaningful improvement in FMAUE (median 21), exceeding the minimal clinically important difference (MCID = 7.35), whereas the control group showed smaller gains (2.50) that did not reach clinical relevance. Both groups improved significantly over time; however, between group differences were not statistically significant (P > 0.05). No significant changes were observed in quality of life, mood, or caregiver burden. Conclusions: NIVR using MindMotion GO is a safe and feasible intervention that can induce clinically meaningful improvements in upper limb motor function in chronic stroke patients. These findings support the incorporation of accessible, taskoriented virtual rehabilitation strategies in longterm stroke care.
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