Virtual Reality Training Affects on Motor Functions and Mental Health in Stroke Patients
Condition: Stroke; Motor Disorders; Affective Symptoms; Gait Disorder, Sensorimotor
MeSH terms: Stroke; Gait Disorders, Neurologic; Motor Disorders; Affective Symptoms
Study type: Interventional

Summary: 
      In our study, we tested the hypothesis of the safe effect applicability of motor training in
      the immersion high-tech polymodal VR system not only on the parameters of balance, gait, and
      motor status of the patient, but also on his cognitive functions and mental health in
      patients with a degree of disability no more than 3 points on a scale Rankin.
    

Detailed description: 
      The neurological consequences of stroke cover the motor, sensory, visual, affective,
      cognitive and speech spheres. 55-75% of stroke survivors suffer from motor impairments,
      caused, inter alia, by hemiparesis, which substantially reduce the quality of their life. In
      addition, neurocognitive functions, especially memory, visual-constructive abilities and
      executive functions, are often affected by stroke. Cognitive impairments appear in 83%
      patients in at least one cognitive domain, whereas in 50% patients appear in multiple (≥3)
      domains. These disorders affect the quality of life of patients, their skills of daily
      activity (the ability to go to the store, prepare food, plan their actions for organizing a
      daily routine), social adaptation. One of the rehabilitation methods that are comprehensively
      suitable for the recovering on of stroke consequences is the intervention using virtual
      reality. The VR method is used for the rehabilitation of stroke patients with various motor
      and neurocognitive deficits: one-sided spatial ignorance, disorders of attention, memory,
      mood, visual-spatial functions, and constructive abilities.

      In our study, we tested the hypothesis of the applicability of the safe effect of motor
      training in the immersion high-tech polymodal VR system not only on the parameters of
      balance, gait, and motor status of the patient, but also on his cognitive functions and
      mental health in patients with a degree of disability no more than 3 score on a modified
      Rankin Scale.

      Stroke patients participated in the study in Federal Center of Cerebrovascular Pathology and
      Stroke, Russian Federation Ministry of Health in Moscow, Russia. The study was run between
      October 2019 and July 2020 and was approved by a local ethic committee and followed
      principles of the Declaration of Helsinki. The patients stayed in a 24-hour hospital and
      underwent a rehabilitation course. This course included a VR Trainig of 10 sessions of 40
      minutes each, which the patients took over two weeks. VR training was conducted on the GRAIL
      system equipment (Motekforce, Netherlands), consisting of a semi-cylindrical screen,
      treadmill, 10 infrared cameras (Vicon, UK) and reflective markers, and software providing
      biofeedback in real time. For complex recovery in VR, exercises stimulate the motor,
      cognitive and behavioral spheres, including visual-spatial orientation, the process of
      attention (with one and duai-task), executive functions, lowering the level of anxiety,
      hand-eye coordination and balance.Training applications were based on the therapeutic goals
      for every patient, according to postural stability and gait adaptation.

      Before and after the end of the training, the patient's condition was assessed, including
      measurements in motor and daily living activity, measurements in mental health, measurements
      in Virtual Reality.
    

Intervention name(s): Training on VR
Intervention type(s): Other
Intervention description(s): The training is aimed at improving the functioning of the motor sphere, including balance, gait, and upper limb function, as well as increasing the level of motivation and reducing the level of anxiety and depression. Game applications were selected based on therapeutic tasks of motor recovery.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Diagnostic
Keywords: Stroke; Virtual reality; Rehabilitation; Motion capture