The study aimed to investigate the effect of exergames using virtual reality with head mounted device on motor recovery of upper extremities in chronic stroke patients.

This is a crossover study for comparing conventional occupational therapy and exercise with game format using virtual reality (virtual reality exergame). The virtual reality exergame is designed to maximize the movement of upper extremities, primary to the shoulder and elbow. Fifteen chronic stroke patient will receive conventional occupational treatment and virtual reality exergame in random order with a two-week-washout period. Outcome measures will be evaluated within two days before and after each treatment, conventional treatment and virtual reality exergame.

*Due to recruitment challenges, the anticipated enrollment has been revised from 36 to 15.

Inclusion Criteria:

• Chronic stroke patients who have passed 6 months or more without additional stroke after the first stroke
• Patients with upper extremity dysfunction due to stroke (ischemic, hemorrhagic)
• Patients who can move the upper extremity against gravity with a manual muscle test of grade 3 or higher in the affected shoulder and elbow, respectively
• Patients who can stably maintain a sitting position
• Patients who voluntarily agreed to participate in the study

Exclusion Criteria:

• Patients with moderate or severe cognitive impairment with a score of 18 or less on the Mini-Mental Status Examination (K-MMSE)
• Patients with other causes of upper extremity dysfunction, such as peripheral nerve damage, joint disease, etc.
• Patients with a history of severe vertigo or epilepsy
• Patients with medical reasons such as medical conditions that make it difficult to participate in research
• Patients who may be pregnant or who are pregnant or lactating