Increasing upper limb training intensity in chronic stroke using embodied virtual reality: a pilot study.

Détails

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Etat: Serval
Version: Final published version
ID Serval
serval:BIB_EFADC9438A51
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Increasing upper limb training intensity in chronic stroke using embodied virtual reality: a pilot study.
Périodique
Journal of neuroengineering and rehabilitation
Auteur(s)
Perez-Marcos D., Chevalley O., Schmidlin T., Garipelli G., Serino A., Vuadens P., Tadi T., Blanke O., Millán JDR
ISSN
1743-0003 (Electronic)
ISSN-L
1743-0003
Statut éditorial
Publié
Date de publication
17/11/2017
Peer-reviewed
Oui
Volume
14
Numéro
1
Pages
119
Langue
anglais
Notes
Publication types: Clinical Trial ; Journal Article
Publication Status: epublish
Résumé
Technology-mediated neurorehabilitation is suggested to enhance training intensity and therefore functional gains. Here, we used a novel virtual reality (VR) system for task-specific upper extremity training after stroke. The system offers interactive exercises integrating motor priming techniques and embodied visuomotor feedback. In this pilot study, we examined (i) rehabilitation dose and training intensity, (ii) functional improvements, and (iii) safety and tolerance when exposed to intensive VR rehabilitation.
Ten outpatient stroke survivors with chronic (>6 months) upper extremity paresis participated in a ten-session VR-based upper limb rehabilitation program (2 sessions/week).
All participants completed all sessions of the treatment. In total, they received a median of 403 min of upper limb therapy, with 290 min of effective training. Within that time, participants performed a median of 4713 goal-directed movements. Importantly, training intensity increased progressively across sessions from 13.2 to 17.3 movements per minute. Clinical measures show that despite being in the chronic phase, where recovery potential is thought to be limited, participants showed a median improvement rate of 5.3% in motor function (Fugl-Meyer Assessment for Upper Extremity; FMA-UE) post intervention compared to baseline, and of 15.4% at one-month follow-up. For three of them, this improvement was clinically significant. A significant improvement in shoulder active range of motion (AROM) was also observed at follow-up. Participants reported very low levels of pain, stress and fatigue following each session of training, indicating that the intensive VR intervention was well tolerated. No severe adverse events were reported. All participants expressed their interest in continuing the intervention at the hospital or even at home, suggesting high levels of adherence and motivation for the provided intervention.
This pilot study showed how a dedicated VR system could deliver high rehabilitation doses and, importantly, intensive training in chronic stroke survivors. FMA-UE and AROM results suggest that task-specific VR training may be beneficial for further functional recovery both in the chronic stage of stroke. Longitudinal studies with higher doses and sample sizes are required to confirm the therapy effectiveness.
This trial was retrospectively registered at ClinicalTrials.gov database (registration number NCT03094650 ) on 14 March 2017.
Mots-clé
Adult, Aged, Exercise Therapy/methods, Female, Humans, Male, Middle Aged, Paresis/rehabilitation, Pilot Projects, Recovery of Function, Stroke, Stroke Rehabilitation/methods, User-Computer Interface, Virtual Reality, Embodied feedback, Motor rehabilitation, Neurorehabilitation, Rehabilitation dose, Training intensity, Virtual reality
Pubmed
Web of science
Open Access
Oui
Création de la notice
23/11/2017 21:56
Dernière modification de la notice
09/05/2019 3:13
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