Virtual reality-augmented rehabilitation for patients in sub-acute phase post-stroke: A feasibility study

Upper extremity (UE) rehabilitation is of utmost importance to the achievement of full inclusion and functional independence. Traditionally presented as well as technology-based therapeutic interventions have produced measurable changes in motor function and motor control but fall short of major reductions in disability. Animal models of stroke suggest that the first two weeks to one month post stroke may be a critical time period of increased brain plasticity. This study shows the feasibility of adding one hour of intensive robotic/virtual reality (VR) therapy to on-going rehabilitation in the acute phase of recovery poststroke. All five of the subjects made substantial improvements in Upper Extremity Fugl-Meyer Assessment (UEFMA) scores (mean improvement = 6 points (SD = 2)) as well as improvements in Wolf Motor Function Test (WMFT) time (average decrease = 41% (SD = 35) after training with more consistent changes in the proximal arm portions of the WMFT and the UEFMA as well as in upper arm kinematics. Maps of cortical excitability indicate an increase in both the area of activation and the volume of activation of the first dorsal interosseous (FDI) muscle after a two-week training period.