Virtual reality-augmented rehabilitation in the acute phase post-stroke for individuals with flaccid upper extremities: A feasibility study

Rehabilitation of individuals with flaccid or severely affected upper extremities is challenging due to their limited motor ability and few options for therapeutic training. This initial study tested the feasibility of training individuals with severe hemiparesis using virtual reality (VR) based mirrored feedback and pinch force modulation tasks. The results demonstrated that the simulations were well tolerated early after stroke. Priming effects of the mirror tasks were suggested by increased maximal pinch force immediately after training. Furthermore, despite having no clinically observable movement distally, the subjects were able to consciously activate their muscles as shown by force traces and EMG recorded during the pinch trace task. Motor learning was also suggested by the decrease in Root Mean Square Error (RMSE) during this task. Lastly the benefits of using objective, technology based measurement tools was demonstrated by the ability of the force sensor to detect small changes in force production that could not be measured with a clinical scale of impairment.