Effect of Immersive Virtual Reality Cognitive Rehabilitation on Subacute Stroke Patients (A Pilot Study)

Effect of Cognitive Rehabilitation Using Immersive Virtual Reality on Cognitive Function and Functional Activity of Subacute Stroke Patients: A Pilot Randomized Controlled Trial

This pilot randomized controlled trial aims to evaluate the effectiveness of cognitive rehabilitation using an immersive Virtual Reality (VR) system compared to conventional paper-and-pencil cognitive training in subacute stroke patients. A total of 22 participants will be randomly assigned to either the VR intervention group (n=11) or the conventional control group (n=11). The study will measure changes in cognitive function and functional independence

Cognitive impairment is a common and debilitating consequence of stroke that hinders functional recovery. This pilot study investigates immersive Virtual Reality (VR) as a novel, engaging modality for cognitive rehabilitation in subacute stroke patients.

Twenty-two eligible subacute stroke patients treated at Dr. Hasan Sadikin General Hospital will be recruited and randomized into two parallel arms. The experimental group (n=11) will receive cognitive rehabilitation using an immersive VR system, while the active control group (n=11) will receive conventional cognitive rehabilitation using standardized paper-and-pencil tests. Both interventions will be administered alongside standard stroke rehabilitation care. Assessments will be conducted at baseline and post-intervention to evaluate cognitive improvement using the Indonesian version of the Montreal Cognitive Assessment (MoCA-INA) and functional activity using the Functional Independence Measure (FIM).

Inclusion Criteria:

• Male or female aged 40-59 years old
• Stroke patient 2-4 months onset of stroke
• Burnstorm stage V or above
• First-time stroke that has been diagnosed by a neurologist with CT scan and/or MRI
• Stroke risk factors and comorbidities are controlled with medication
• Mild and moderate level of cognitive impairment based on MOCA and can use devices
• Participants can grip and operate VR console with their hand
• Participants can follow instructions and exercises
• Participants were cooperative and willing to participate in the study by signing a consent form after receiving an explanation.

Exclusion Criteria:

• Participants with severe cognitive impairment or aphasia struggle to understand instructions
• Neglected patient
• Participants with low vision unable to perceive content on screens
• Participant with eyestrain characterized by blurring vision, dry eyes, foreign body sensation, itching watering, neck stiffness and backache
• Severe musculoskeletal disorders causing problem in standing and following instruction