Article

OBJECTIVE: To assess the feasibility of conducting a randomised controlled trial
of a home-based virtual reality system for rehabilitation of the arm following stroke. DESIGN: Two group feasibility randomised controlled trial of intervention
versus usual care. SETTING: Patients' homes. PARTICIPANTS: Patients aged 18 or
over, with residual arm dysfunction following stroke and no longer receiving any
other intensive rehabilitation. INTERVENTIONS: Eight weeks' use of a low cost
home-based virtual reality system employing infra-red capture to translate the
position of the hand into game play or usual care. MAIN MEASURES: The primary
objective was to collect information on the feasibility of a trial, including
recruitment, collection of outcome measures and staff support required. Patients
were assessed at three time points using the Wolf Motor Function Test, Nine-Hole
Peg Test, Motor Activity Log and Nottingham Extended Activities of Daily Living.
RESULTS: Over 15 months only 47 people were referred to the team. Twenty seven
were randomised and 18 (67%) of those completed final outcome measures. Sample
size calculation based on data from the Wolf Motor Function Test indicated a
requirement for 38 per group. There was a significantly greater change from
baseline in the intervention group on midpoint Wolf Grip strength and two
subscales of the final Motor Activity Log. Training in the use of the equipment
took a median of 230 minutes per patient. CONCLUSIONS:
To achieve the required
sample size, a definitive home-based trial would require additional strategies to
boost recruitment rates and adequate resources for patient support.

Langue : ANGLAIS