Virtual Reality Training Can Aid in Stroke Recovery

New research suggests that VR exercises are just as effective as traditional physical therapy.

A new study out of Europe suggests that virtual reality training is equally as effective as traditional physical therapy when trying to help stroke victims recover use of their arms and hands.

Published in the November issue of Neurology, the medical journal of the American Academy of Neurology, the research found that a basic VR system can be just as good as in-person therapy for certain kinds of recovery programs. The technology could be used to allow people to use commercial VR systems remotely, from their homes, saving time and money.

Iris Brunner, author of the new study and associate professor with the University of Aarhus, Denmark, said the VR system is fundamentally different from previous remote training systems, in which patients might work with a therapist on a live feed or videotape.

“VR training is different in that you are really interacting with what you see on a screen,” Brunner told Seeker. “The patients' movements are transferred to either virtual arms or objects on a screen and their movements receive different kinds of feedback, which again is important for the reorganization of the brain after stroke.”

The study involved 120 people, average age 62, who had suffered a stroke about a month previous to testing. The goal of the experiments was to help participants recover from mild to severe muscle weakness in their wrists, hands, or upper arms. Half of the group was prescribed standard physical therapy, and the other half worked exclusively with the new VR system.

Participants in the study were monitored for four weeks, undergoing four to five hour-long training sessions per week. Arm and hand functioning was tested at the beginning of the study, immediately after the training ended, and again three months after the start of the study.

“Both groups had substantial improvement in their functioning, but there was no difference between the two groups in the results,” Brunner said. “These results suggest that either type of training could be used, depending on what the patient prefers.”

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The VR physical therapy kit uses a standard television or computer monitor hooked up to a console and a set of virtual reality gloves. System software leads the patients through several exercises and games and then tracks the results using sensors within the VR gloves.

“A typical game would have the patient grasping different objects that come towards him or her,” Brunner said. “The advantage with rehabilitation software is that the therapist can choose the time between the objects, the time to grasp, on which side they are presented and much more.”

“Another game,” she added, “would be steering a plane with a movement of the hand or fingers, with one hand or both.”

The VR system requires dedicated hardware, but Brunner said it's possible that the technology could be adapted to commercial VR rigs like the Oculus Rift, Samsung Gear, or Sony PlayStation VR. The VR rehab technique could also potentially work with more basic motion tracking systems like Microsoft Kinect.

“There are already some very good rehab software programs on the market that are used in connection with a Kinect camera,” Brunner said. “However, it is still a challenge to transfer fine motor movements without sensors. Moreover, it is important that the software can be adapted to people with stroke.”

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The study was supported by the Norwegian Research Council, Regional Hospital Central Jutland Research Fund, Western Norway Regional Health Authority, Norwegian Fund for Postgraduate Training in Physiotherapy, and Danish Physiotherapists' Research Fund.

Brunner said that developing a virtual reality option for stroke patients could help doctors and clinicians reach a wider range of people in need, while also reducing costs for the patient. The VR element might also help encourage people to complete their prescribed physical therapy exercises.

“VR is not a miracle cure, but it can be motivating and fun for many patients,” she said.

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