Effect of Virtual Reality training on reach after stroke

To stimulate restoration of arm function after stroke, intensive and
task-specific training is essential. To implement this, the application of
virtual reality (VR) in rehabilitation is promising. Integration of stimuli and
feedback in a rehabilitation game, taking principles of motor relearning into
account, allows high motivation for patients during training. Additionally, VR
can automate and intensify treatment, since patients can practice more
independently, without the need for one-to-one supervision. This is an
important issue in coming years with respect to the ageing of the population,
leading to increased demand, but decreased availability of physical and
occupational therapists.
Previous research of this group showed that arm training using a specifically
developed game for rehabilitation (FurballHunt), combined with arm support, can
improve reaching. However, this pilot study did not discern between the effect
of arm support and the added value of training with a rehabilitation game. When
training using a rehabilitation game proves (at least) as effective as
conventional therapy, this already is promising for applying VR in
rehabilitation, regarding independency during training.

To compare the effect of a stimulus rich context, specifically developed for
rehabilitation (rehab game), with a less rich context (conventional exercises)
during reach training for restoration of arm function in chronic stroke
patients.

Pilot randomised controlled trial with one baseline measurement pre-training
and two end measurements post-training (within one week and follow-up after one
month).

Twenty stroke patients receive reach training for the affected arm during 6
weeks, 3 times 30 minutes per week. The intervention group (10 persons,
randomized) will train using the FurballHunt game and the control group (10
persons, randomized) will perform standardized reaching exercises in a
conventional physical therapy setting, with equal intensity.

The risks for the participants are limited to a minimum, since the movement
tasks consist of functional and familiar arm movements, all executed within the
ability of the person, while sitting. Furthermore, the measurements in this
study are non-invasive (motion analysis, functional scales) and pose no risk or
inconvenience for the participants.
Participation in this study can present an immediate benefit for the
participant, in the sense that additional training of reaching of the affected
arm is received. Whether, and to what extent, this benefit will present, can*t
be predicted, because getting insight in this information is the purpose of
this study.