Effect of Virtual Reality Game on Upper Limb Movement in Individuals With Stroke

Study Overview
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Brief Summary
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Individuals with stroke show abnormal movement pattern of upper limb. The movement pattern needs to be corrected. There are several methods to train normal movement. Exercise with technology is an active movement and affects sensory and cognitive systems. It may benefit to individuals with stroke in training.

Detailed Description
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Individuals with stroke sign informed consent. They are trained with virtual reality game with and without feedback from a researcher. Age-matched healthy play the same game as individuals with stroke do. Both individuals with stroke and healthy are measured upper limb movement pattern.

Official Title
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Effect of Game-based Virtual Reality Training on Upper Extremity Movement in Individuals With Subacute Stroke

Conditions
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Stroke, Movement, Abnormal

Intervention / Treatment
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* Other: Virtual reality with feedback
* Other: Virtual reality without feedback
* Other: Healthy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Individuals with stroke 45 - 65 years old First ischemic or hemorrhagic stroke Right hemiparesis Right dominant handedness Within 6 months after stroke Discharge from hospital and stay at home Normal dynamic sitting balance At least 120 degrees of shoulder flexion and 45 degrees of shoulder extension by passive range of motion Active movement at least stage 3 by Chedoke-McMaster Stroke Assessment Muscle tone graded 1-2 by Modified Ashworth Scale in 2 of 3 muscle groups including shoulder adductor, internal rotator or/and elbow flexor groups No cognitive impairment Healthy individuals Have same gender and age within range of ±5 years of individuals with stroke Right handedness Active range of motion of shoulder flexion and extension at least 120°and 45° respectively No cognitive impairment Exclusion Criteria: Individual with stroke and healthy Have cyber-sickness Obesity Ataxic movement Loss visual field or visual neglect Loss exteroceptive sensation Impaired or loss proprioceptive sensation Receive the occupation therapy on upper extremity Muscle contracture at the scapula, shoulder and elbow Pain at the scapula, shoulder and elbow History of fracture or surgery at head, shoulder, scapula, and elbow Shoulder subluxation Other neurological disorders Uncontrolled hypertension Myocardial infarction Seizure or epilepsy Pacemaker or hemodialysis vascular access

Ages Eligible for Study
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Minimum Age: 45 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: virtual reality with feedback<br>Participants received training via virtual reality game with feedback, 60 minutes/day, 3 days/week for 4 weeks, then follow up after 4 weeks. | Other: Virtual reality with feedback<br>* Individuals with stroke play game with correction of movement.<br>|
| Active Comparator: virtual reality without feedback<br>Participants received training via virtual reality game without feedback, 60 minutes/day, 3 days/week for 4 weeks, then follow up after 4 weeks. | Other: Virtual reality without feedback<br>* Individuals with stroke play game without correction of movement.<br>|
| Other: Healthy<br>Participants do not play virtual reality game. | Other: Healthy<br>* Healthy do not play game<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| kinematic data | angle of shoulder, elbow, and forearm | 10 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Upper limb performance | doing task according to Fugl Mayer | 10 minutes | 
| muscle tone | assessing muscles of shoulder, elbow, and forearm according to Modified Ashworth Scale | 2 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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virtual reality, feedback