Upper Extremity Rehabilitation Using Fully Immersive Virtual Reality Games With a Head Mount Display: A Feasibility Study.

BACKGROUND

Rehabilitation therapy using a virtual reality (VR) system for stroke patients has gained attention. However, few studies have investigated fully immersive VR using a head-mount display (HMD) for upper extremity rehabilitation in stroke patients.

OBJECTIVE

To investigate the feasibility, preliminary efficacy, and usability of a fully immersive VR rehabilitation program using a commercially available HMD for upper-limb rehabilitation in stroke patients.

DESIGN

A feasibility study.

SETTING

Two rehabilitation centers.

PARTICIPANTS

Twelve stroke patients with upper extremity weakness.

INTERVENTIONS: Five upper extremity rehabilitation tasks were implemented in a virtual environment, and the participants wore an HMD (HTC Vive) and trained with appropriate tasks. Participants received a total of 10 sessions two to three times a week, consisting of 30 minutes per session.

MAIN OUTCOME MEASURES: Both patient participation and adverse effects of VR training were monitored. Primary efficacy was assessed using functional outcomes (Action Research Arm Test, Box and Block Test, and modified Barthel Index), before and after the intervention. Usability was assessed using a self-reported questionnaire.

RESULTS

Three patients discontinued VR training, and nine patients completed the entire training sessions and there were no adverse effects due to motion sickness. The patients who received all sessions showed significant functional improvement in all outcome measures after training (P < .05 for all measures). The overall satisfaction was 6.3 ± 0.8 on a 7-point Likert scale in all participants.

CONCLUSIONS

A fully immersive VR rehabilitation program using an HMD for rehabilitation of the upper extremities following stroke is feasible and, in this small study, no serious adverse effects were identified.

LEVEL OF EVIDENCE: IV.