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Feasibility of using immersive virtual functional rehabilitation for recovery of upper extremity function in patients with early-stage stroke: a pilot study
Background: Immersive virtual reality (IVR)-based rehabilitation provides high-intensity, engaging, task-oriented training and motor exploration for upper limb (UL) recovery post-stroke. However, its feasibility and dose-response effects remain unclear.
Objective: To evaluate the feasibility and dose-response effects of IVR-based rehabilitation for UL recovery in early stroke patients.
Methods: A pilot trial included 12 early-stage stroke patients randomized into two groups: Group A (10 IVR sessions + conventional rehabilitation [CR]) and Group B (20 IVR sessions + CR). Feasibility outcomes included adherence, usability (User Satisfaction Evaluation Questionnaire [USEQ], System Usability Scale [SUS]), system operability, and adverse effects. Motor outcomes, categorized by the International Classification of Functioning, Disability, and Health (ICF), assessed UL impairment (Fugl-Meyer Assessment, Medical Research Council scale), activity (Box and Block Test), and participation (Motor Activity Log 30). Blinded therapists conducted assessments at baseline, post-intervention, and 4-week follow-up. Dose-response was analyzed using Probability of Superiority (PS).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 10 session | Other | Participants receive 10 sessions of intervention with virtual inmersive reality. Virtual reality with hand tracking and immersive environment |
|
| 20 sessions | Other | Participants receive 20 sessions of intervention with virtual inmersive reality. Virtual reality with hand tracking and immersive environment. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Immersive virtual reality | Device | Virtual reality with hand tracking and immersive environment |
|
| Measure | Description | Time Frame |
|---|---|---|
| System Usability Scale [SUS] | Questionnaire completed by the handlers who administer the immersive virtual reality system | The treatment providers fill out the questionnaire at the end of treatment. It depends of the group patient: 10 or 20-session treatment. |
| User Satisfaction Evaluation Questionnaire [USEQ] | Questionnaire of 5 questions with 5 options based on likert rate. Is filled for the patient recruited | Administered within the first 7 days of using the immersive virtual reality device |
| Measure | Description | Time Frame |
|---|---|---|
| Fugl-Meyer Assessment for Upper Extremity | Clinical assessment scale for upper extremity function. It evaluates various functional areas of the upper extremity: wrist, hand, coordination, and speed. This provides a total of 66 motor function points. | It is administered in three stages: Baseline or day 1 (pre treatment). In the week number 4 (post treatment). Up to 8 weeks (follow-up). Through study completion, an average of 6 months. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Clinica Alemana | Santiago | Santiago Metropolitan | 8340518 | Chile |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36772757 | Result | Demeco A, Zola L, Frizziero A, Martini C, Palumbo A, Foresti R, Buccino G, Costantino C. Immersive Virtual Reality in Post-Stroke Rehabilitation: A Systematic Review. Sensors (Basel). 2023 Feb 3;23(3):1712. doi: 10.3390/s23031712. | |
| 41416487 | Derived | Peralta-Wieland B, Vasquez-Torres R, Maldonado-Diaz M, Yoma M. Immersive Virtual Reality-Based Rehabilitation for Upper Limb Recovery in Acute and Subacute Stroke Patients: A Feasibility Study. Physiother Res Int. 2026 Jan;31(1):e70151. doi: 10.1002/pri.70151. |
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Pilot study evaluating the feasibility of using an immersive virtual reality device in patients with stroke in the acute and sub-acute stages. Preliminary functional outcomes about upper extremity function are also assessed.
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| Immersive Virtual Reality | Device | Immersive virtual reality is a digital therapeutic approach to enhance neuroplasticity using virtual environment and hand tracking for functional motion in upper extremity |
|
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| Motor Activity Log | Questionnaire of 30 questions for quality of functional movement and 30 questions of quantity of functional movement of upper extremity. The maximal score is 150 for both quantity and quality. | It is administered in three stages: Baseline or day 1 (pre treatment). In the week number 4 (post treatment). Up to 8 weeks (follow-up). Through study completion, an average of 6 months. |
| Box and block test | Patient must to pick up little boxes and carry on in a standarized box. Patient must perform the test with both hands, with paresis and without paresis in 1 minute per each upper extremity. | It is administered in three stages: Baseline or day 1 (pre treatment). In the week number 4 (post treatment). Up to 8 weeks (follow-up). Through study completion, an average of 6 months. |
| Medical research council | Manual test muscle that use oxford graduation. M0 total weakness to M5 is normal strenght | It is administered in three stages: Baseline or day 1 (pre treatment). In the week number 4 (post treatment). Up to 8 weeks (follow-up). Through study completion, an average of 6 months. |
| ID | Term |
|---|---|
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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