Virtual Reality Therapy for Patients with Stroke

More than two thirds of the individuals who have strokes are over the age of 65. Therefore, as the global population continues to age, the risk of stroke is expected to increase substantially. Virtual reality (VR) is an emerging therapy that holds promise for the rehabilitation of patients with chronic stroke conditions. VR is an interactive, computer-based simulation of real life tasks, occurring in real time. The aim of this review was to explore whether non-immersive VR could be used to effectively improve fine motor function of the affected upper extremity in patients with chronic stroke. Ten studies examining non-immersive VR for the purpose of chronic stroke rehabilitation were included for review. Studies utilized a variety of VR-based interventions, reporting trends toward improvement on nearly all outcome measures. Results were examined at the levels of “body structure and function” and “activity” according to the International Classification of Functioning. Across the studies, significant improvements were reported for the Jebsen Test of Hand Function, the Box and Block Test, participants’ finger fractionation, finger tracking measures, and time from peak hand velocity to movement of an object. However, considerable variability in participants’ recovery rates of fine motor function across the studies suggests that the results should be interpreted with caution. More research using randomized controlled trial designs will clarify evidence surrounding the amount of improvement that can be experienced with non-immersive VR-based interventions. This review provides justification for continued investigation within the field of motor skill recovery in patients with chronic stroke. neuroplasticity, which can be described as the brain’s natural tendency to reorganize itself in response to changing internal and external demands [1,13]. Stroke rehabilitation has become a popular platform for neuroplasticity-related research, as motor recovery from stroke aptly demonstrates the brain’s malleability and capacity for ‘rewiring’ post-injury [11]. It is of importance to note that this plasticity exists as a function in both healthy and damaged brains alike [14]. Furthermore, the brain’s remarkable ability to promote repair following a stroke has been observed to extend years beyond the initial injury [4,15]. The Motor Recovery ‘Plateau’ Despite this notion of an incessantly plastic brain, the majority of recovery of general motor function has typically been observed within the first six to twelve months post-stroke [12,16]. The rate at which recovery occurs appears to decelerate as time passes, with recovery most rapid in the first month, slowing in subsequent months, and eventually reaching a ‘plateau’ [15,16]; that is, a point in time during the course of rehabilitation in which a patient no longer exhibits signs of improvement in response to therapeutic intervention [15]. This observable plateau holds serious implications for stroke survivors, as this perceived cessation of progress often provides the grounds for discharge from rehabilitative programs [17,18]. As such, reservations regarding the cost-effectiveness are warranted, since the apparent widespread presence of a motor recovery plateau suggests a limit to Citation: LeBlanc S, Paquin K, Carr K, Horton S (2013) Non-immersive Virtual Reality for Fine Motor Rehabilitation of Functional Activities in Individuals with Chronic Stroke: A Review. Aging Sci 1: 105. doi:10.4172/jasc.1000105