Can specific virtual reality combined with conventional rehabilitation improve poststroke hand motor function? A randomized clinical trial
Abstract Trial objective To verify whether conventional rehabilitation combined with specific virtual reality is more effective than conventional therapy alone in restoring hand motor function and muscle tone after stroke. Trial design This prospective single-blind randomized controlled trial compar...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | Journal of NeuroEngineering and Rehabilitation |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12984-023-01170-3 |
| _version_ | 1797850148743675904 |
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| author | Marta Rodríguez-Hernández Begoña Polonio-López Ana-Isabel Corregidor-Sánchez José L. Martín-Conty Alicia Mohedano-Moriano Juan-José Criado-Álvarez |
| author_facet | Marta Rodríguez-Hernández Begoña Polonio-López Ana-Isabel Corregidor-Sánchez José L. Martín-Conty Alicia Mohedano-Moriano Juan-José Criado-Álvarez |
| author_sort | Marta Rodríguez-Hernández |
| collection | DOAJ |
| description | Abstract Trial objective To verify whether conventional rehabilitation combined with specific virtual reality is more effective than conventional therapy alone in restoring hand motor function and muscle tone after stroke. Trial design This prospective single-blind randomized controlled trial compared conventional rehabilitation based on physiotherapy and occupational therapy (control group) with the combination of conventional rehabilitation and specific virtual reality technology (experimental group). Participants were allocated to these groups in a ratio of 1:1. The conventional rehabilitation therapists were blinded to the study, but neither the participants nor the therapist who applied the virtual reality–based therapy could be blinded to the intervention. Participants Forty-six patients (43 of whom completed the intervention period and follow-up evaluation) were recruited from the Neurology and Rehabilitation units of the Hospital General Universitario of Talavera de la Reina, Spain. Intervention Each participant completed 15 treatment sessions lasting 150 min/session; the sessions took place five consecutive days/week over the course of three weeks. The experimental group received conventional upper-limb strength and motor training (100 min/session) combined with specific virtual reality technology devices (50 min/session); the control group received only conventional training (150 min/session). Results As measured by the Ashworth Scale, a decrease in wrist muscle tone was observed in both groups (control and experimental), with a notably larger decrease in the experimental group (baseline mean/postintervention mean: 1.22/0.39; difference between baseline and follow-up: 0.78; 95% confidence interval: 0.38–1.18; effect size = 0.206). Fugl-Meyer Assessment scores were observed to increase in both groups, with a notably larger increase in the experimental group (total motor function: effect size = 0.300; mean: − 35.5; 95% confidence interval: − 38.9 to − 32.0; wrist: effect size = 0.290; mean: − 5.6; 95% confidence interval: − 6.4 to − 4.8; hand: effect size = 0.299; mean: − -8.9; 95% confidence interval: − 10.1 to − 7.6). On the Action Research Arm Test, the experimental group quadrupled its score after the combined intervention (effect size = 0.321; mean: − 32.8; 95% confidence interval: − 40.1 to − 25.5). Conclusion The outcomes of the study suggest that conventional rehabilitation combined with a specific virtual reality technology system can be more effective than conventional programs alone in improving hand motor function and voluntary movement and in normalizing muscle tone in subacute stroke patients. With combined treatment, hand and wrist functionality and motion increase; resistance to movement (spasticity) decreases and remains at a reduced level. Trials Registry: International Clinical Trials Registry Platform: ISRCTN27760662 (15/06/2020; retrospectively registered). |
| first_indexed | 2024-04-09T18:55:42Z |
| format | Article |
| id | doaj.art-20f9d0a50294410bb72ccd9fedb654d2 |
| institution | Directory Open Access Journal |
| issn | 1743-0003 |
| language | English |
| last_indexed | 2024-04-09T18:55:42Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of NeuroEngineering and Rehabilitation |
| spelling | doaj.art-20f9d0a50294410bb72ccd9fedb654d22023-04-09T11:10:00ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032023-04-0120111410.1186/s12984-023-01170-3Can specific virtual reality combined with conventional rehabilitation improve poststroke hand motor function? A randomized clinical trialMarta Rodríguez-Hernández0Begoña Polonio-López1Ana-Isabel Corregidor-Sánchez2José L. Martín-Conty3Alicia Mohedano-Moriano4Juan-José Criado-Álvarez5Faculty of Health Sciences, University of Castilla-La ManchaFaculty of Health Sciences, University of Castilla-La ManchaFaculty of Health Sciences, University of Castilla-La ManchaFaculty of Health Sciences, University of Castilla-La ManchaFaculty of Health Sciences, University of Castilla-La ManchaFaculty of Health Sciences, University of Castilla-La ManchaAbstract Trial objective To verify whether conventional rehabilitation combined with specific virtual reality is more effective than conventional therapy alone in restoring hand motor function and muscle tone after stroke. Trial design This prospective single-blind randomized controlled trial compared conventional rehabilitation based on physiotherapy and occupational therapy (control group) with the combination of conventional rehabilitation and specific virtual reality technology (experimental group). Participants were allocated to these groups in a ratio of 1:1. The conventional rehabilitation therapists were blinded to the study, but neither the participants nor the therapist who applied the virtual reality–based therapy could be blinded to the intervention. Participants Forty-six patients (43 of whom completed the intervention period and follow-up evaluation) were recruited from the Neurology and Rehabilitation units of the Hospital General Universitario of Talavera de la Reina, Spain. Intervention Each participant completed 15 treatment sessions lasting 150 min/session; the sessions took place five consecutive days/week over the course of three weeks. The experimental group received conventional upper-limb strength and motor training (100 min/session) combined with specific virtual reality technology devices (50 min/session); the control group received only conventional training (150 min/session). Results As measured by the Ashworth Scale, a decrease in wrist muscle tone was observed in both groups (control and experimental), with a notably larger decrease in the experimental group (baseline mean/postintervention mean: 1.22/0.39; difference between baseline and follow-up: 0.78; 95% confidence interval: 0.38–1.18; effect size = 0.206). Fugl-Meyer Assessment scores were observed to increase in both groups, with a notably larger increase in the experimental group (total motor function: effect size = 0.300; mean: − 35.5; 95% confidence interval: − 38.9 to − 32.0; wrist: effect size = 0.290; mean: − 5.6; 95% confidence interval: − 6.4 to − 4.8; hand: effect size = 0.299; mean: − -8.9; 95% confidence interval: − 10.1 to − 7.6). On the Action Research Arm Test, the experimental group quadrupled its score after the combined intervention (effect size = 0.321; mean: − 32.8; 95% confidence interval: − 40.1 to − 25.5). Conclusion The outcomes of the study suggest that conventional rehabilitation combined with a specific virtual reality technology system can be more effective than conventional programs alone in improving hand motor function and voluntary movement and in normalizing muscle tone in subacute stroke patients. With combined treatment, hand and wrist functionality and motion increase; resistance to movement (spasticity) decreases and remains at a reduced level. Trials Registry: International Clinical Trials Registry Platform: ISRCTN27760662 (15/06/2020; retrospectively registered).https://doi.org/10.1186/s12984-023-01170-3Randomized controlled trialStrokeNeurorehabilitationMotor recoveryHandVirtual reality-based therapy |
| spellingShingle | Marta Rodríguez-Hernández Begoña Polonio-López Ana-Isabel Corregidor-Sánchez José L. Martín-Conty Alicia Mohedano-Moriano Juan-José Criado-Álvarez Can specific virtual reality combined with conventional rehabilitation improve poststroke hand motor function? A randomized clinical trial Journal of NeuroEngineering and Rehabilitation Randomized controlled trial Stroke Neurorehabilitation Motor recovery Hand Virtual reality-based therapy |
| title | Can specific virtual reality combined with conventional rehabilitation improve poststroke hand motor function? A randomized clinical trial |
| title_full | Can specific virtual reality combined with conventional rehabilitation improve poststroke hand motor function? A randomized clinical trial |
| title_fullStr | Can specific virtual reality combined with conventional rehabilitation improve poststroke hand motor function? A randomized clinical trial |
| title_full_unstemmed | Can specific virtual reality combined with conventional rehabilitation improve poststroke hand motor function? A randomized clinical trial |
| title_short | Can specific virtual reality combined with conventional rehabilitation improve poststroke hand motor function? A randomized clinical trial |
| title_sort | can specific virtual reality combined with conventional rehabilitation improve poststroke hand motor function a randomized clinical trial |
| topic | Randomized controlled trial Stroke Neurorehabilitation Motor recovery Hand Virtual reality-based therapy |
| url | https://doi.org/10.1186/s12984-023-01170-3 |
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