Article

PURPOSE: To evaluate feasibility and neurophysiological changes after virtual
reality (VR)-based training of upper limb (UL) movements. METHOD: Single-case
A-B-A-design with two male stroke patients (P1:67 y and 50 y, 3.5 and 3 y after
onset) with UL motor impairments, 45-min therapy sessions 5x/week over 4 weeks.
Patients facing screen, used bimanual data gloves to control virtual arms. Three
applications trained bimanual reaching, grasping, hand opening. Assessments
during 2-week baseline, weekly during intervention, at 3-month follow-up (FU):
Goal Attainment Scale (GAS), Chedoke Arm and Hand Activity Inventory (CAHAI),
Chedoke-McMaster Stroke Assessment (CMSA), Extended Barthel Index (EBI), Motor
Activity Log (MAL). Functional magnetic resonance imaging scans (FMRI) before,
immediately after treatment and at FU. RESULTS: P1 executed 5478 grasps (paretic
arm). Improvements in CAHAI (+4) were maintained at FU. GAS changed to +1
post-test and +2 at FU. P2 executed 9835 grasps (paretic arm). CAHAI improvements
(+13) were maintained at FU. GAS scores changed to -1 post-test and +1 at FU. MAL
scores changed from 3.7 at pre-test to 5.5 post-test and 3.3 at FU. CONCLUSION:
The VR-based intervention was feasible, safe, and intense. Adjustable application
settings maintained training challenge and patient motivation. ADL-relevant UL
functional improvements persisted at FU and were related to changed cortical
activation patterns. Implications for Rehabilitation YouGrabber trains uni- and
bimanual upper motor function. Its application is feasible, safe, and intense.
The control of the virtual arms can be done in three main ways: (a) normal (b)
virtual mirror therapy, or (c) virtual following. The mirroring feature provides
an illusion of affected limb movements during the period when the affected upper
limb (UL) is resting. The YouGrabber training led to ADL-relevant UL functional
improvements that were still assessable 12 weeks after intervention finalization
and were related to changed cortical activation patterns.

Langue : ANGLAIS