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Virtual reality for upper extremity rehabilitation in early stroke: a pilot randomized controlled trial [with consumer summary]
Yin CW, Sien NY, Ying LA, Chung SF-CM, Leng DTM
Clinical Rehabilitation 2014 Nov;28(11):1107-1114
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: To investigate the effect of virtual reality (VR) rehabilitation on upper extremity motor performance of patients with early stroke. DESIGN: Pilot randomized controlled trial. SETTING: Rehabilitation wards. PARTICIPANTS: Twenty three adults with stroke (mean age (SD) 58.35 (13.45) years and mean time since stroke (SD) 16.30 (7.44) days). INTERVENTIONS: Participants were randomly assigned to VR group (n = 11) or control group (n = 12). VR group received nine 30 minutes upper extremity VR therapy in standing (five weekdays in two weeks) plus conventional therapy, which included physical and occupational therapy. Control group received only conventional therapy, which was comparable to total training time received by VR group (mean training hours (SD) VR 17.07 (2.86); control 15.50 (2.79)). MAIN OUTCOME MEASURES: The main outcome measure was the Fugl-Meyer Assessment (FMA). Secondary outcomes included Action Research Arm Test, Motor Activity Log and Functional Independence Measure. Results were taken at baseline, post intervention and 1-month post intervention. Participants' feedback and adverse effects were recorded. RESULTS: All participants improved in FMA scores (mean change (SD) 11.65 (8.56), p < 0.001). These effects were sustained at one month after intervention (mean (SD) change from baseline 18.67 (13.26), p < 0.001). All other outcome measures showed similar patterns. There were no significant differences in improvement between both groups. Majority of the participants found VR training useful and enjoyable, with no serious adverse effects reported. CONCLUSION: Although additional VR training was not superior to conventional therapy alone, this study demonstrates the feasibility of VR training in early stroke.

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