JMIR Publications

ABSTRACT

Background:

Virtual reality (VR) can supplement exercise therapy for post-stroke upper-arm hemiparesis, but treatments have been largely limited by specialized or costly equipment, hindering replicability and generalizability.

Objective:

This study examined the feasibility of a commercially available bundle of VR supplies to improve hemi-paretic arm function before and after an exergaming program among a person post-stroke.

Methods:

Pre-to-post case study (male, age 72 years) of 20-days of VR exergaming program (1 hour session per day) using a head- mounted display (Meta Quest 2), with adaptive software (WalkinVR) to boost and adjust in-game movements. Measures of upper-arm function were performed at pre (day 0), mid (day 10), and post-intervention (day 21) and included the Wolf Motor Function Test (WMFT), Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Data were descriptively analyzed.

Results:

The participant demonstrated improvement in the mean time to complete tasks of the WMFT by 70.5% (delta=11.73 secs / pre=16.63 secs; effect size=0.54) and 50% (12.96 secs / pre=16.63 secs; effect size=0.59) from pre- to mid- and post-intervention, respectively. WMFT mean functional ability score demonstrated an improvement of 18% (delta=0.46 points / pre=2.67 points; effect size=0.59) and 23% (delta=0.6 points / pre=2.67; effect size=0.79) from pre- to mid- and post-intervention, respectively. Range of motion improved in all joints by an average of 35.64% from pre to post intervention. DASH scores demonstrated minimal improvements across the intervention.

Conclusions:

VR exergaming with adaptive software may elicit clinically meaningful improvements to the functional ability of the hemi-paretic arm. Improvements were substantial, given that benefits were seen as early as 10 days into the program, which warrants further investigation in confirmatory trials. Clinical Trial: N/A.