Accepted for/Published in: JMIR Serious Games
Date Submitted: Sep 22, 2021
Date Accepted: Apr 7, 2022
The Impact of Cognitive Function on Virtual Reality Intervention for Upper Extremity Rehabilitation of Subacute Stroke Patients: A Prospective Controlled Trial with 6 months Follow-up
ABSTRACT
Background:
To date, it remains unclear if cognitive function may influence upper limb functional outcome in patients with stroke who undergo virtual reality intervention and conventional therapy.
Objective:
This study explored the impact of cognitive function on functional outcomes in people with subacute stroke after VR intervention.
Methods:
Stroke patients were first stratified into cognitively normal (CN) and cognitively impaired (CI), followed by allocation to VR or control group (CG). Fugl-Meyer assessment of Upper Extremity (FMA-UE), Barthel Index (BI) and Instrumental Activities of Daily Living (IADL) were recorded at baseline, post intervention, 3 and 6 months post intervention. The between groups and within-group differences were assessed by repeated-measures analysis of variance (ANOVA).
Results:
The between groups comparison indicated FMA-UE, BI and IADL (Time effect p < 0.001) scores improved significantly in both groups post intervention. Repeated-measures ANOVA indicated that FMA-UE，BI and IADL (Time effect p < 0.001) were significantly different in each subgroup post intervention. For BI score, the ANOVA results showed obvious interaction effects (Treatment x Time x Cognitive effect, p = 0.040).
Conclusions:
VR intervention was as effective as traditional conventional therapy in improving upper limb function regardless of cognitive functional level. Stroke patients with impaired cognitive function may gain more improvement in upper limb function and independency in performing activities of daily living after VR-based intervention. Clinical Trial: Chinese Clinical Trial Registry (Registration No.: ChiCTR-IOC-15006064). Registered on 11 May 2015. http://www.chictr.org.cn/showprojen.aspx?proj=10541
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