A Rehabilitation Protocol for Stroke Patients using Virtual Reality

Main Article Content

Moon Fai Chan Senthilkumar Ravindran Hammad Al-Subhi Saif Al-Riyami

Abstract

Rehabilitation training for stroke patients is mostly based on face-to-face contact. This affects the routine training during the coronavirus disease outbreak in many hospitals worldwide, including Oman. Perhaps, this problem can be overcome using a virtual reality system. This protocol study aims to compare the outcome measures of the two groups of stroke patients (virtual reality intervention vs. conventional control) on these two modes of rehabilitation training. A randomized controlled trial with pre-/post-study of 42 stroke patients (21 control vs. 21 intervention) with upper limb motor impairments, aged 18-65 years old, newly admitted to the rehabilitation clinic in Oman, will be recruited.  Basic demographic data and three major outcome assessments will be collected pre-/post-period. Baseline assessment (pre) on admission to the stroke rehabilitation program and after completion (post). Participants will be assessed by Barthel Index, Action Research Arm scale, and time spent per session with costs involved by the workforce in training. Repeated measures general linear model will examine the within, between, and interaction effects while adjusted by demographic data. All analyses will use IBM SPSS software, and a statistical significance level of p<0.05 will be employed. This research protocol aims to evaluate the feasibility and effectiveness of VR in improving motor control in stroke patients with upper limb weakness by comparing a low-cost VR platform with face-to-face training. If the proposed training protocol is helpful and easy to use, it could become a reliable tool to assist healthcare professionals for stroke patients during their rehabilitation training. This protocol will contribute to the theoretical discussion of integrating high-tech equipment with healthcare theory for stroke patients with learning disabilities. Also, adopting a virtual reality system could aid if a sudden pandemic outbreak. It could continue offering its services while maintaining a high standard of care for stroke sufferers.

Keywords: Virtual reality, Rehabilitation program, Stroke patients, Oman

Article Details

How to Cite
CHAN, Moon Fai et al. A Rehabilitation Protocol for Stroke Patients using Virtual Reality. Medical Research Archives, [S.l.], v. 10, n. 12, dec. 2022. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3426>. Date accessed: 29 jan. 2023. doi: https://doi.org/10.18103/mra.v10i12.3426.
Section
Research Articles

References

1. Donkor ES. Stroke in the 21st Century: A Snapshot of the Burden, Epidemiology, and Quality of Life. Stroke Research and Treatment. 2018;3238165. https://doi.org/10.1155/2018/3238165.
2. World Life Expectancy https://www.worldlifeexpectancy.com/oman-stroke. 2021. Accesses June 25, 2022
3. Calabrò RS, Accorinti M, Porcari B, et al. Does hand robotic rehabilitation improve motor function by rebalancing interhemispheric connectivity after chronic stroke? Encouraging data from a randomised-clinical-trial. Clinical neurophysiology: official journal of the International Federation of Clinical Neurophysiology. 2019;130(5):767–780. https://doi.org/10.1016/j.clinph.2019.02.013
4. Hutchinson SL., Lauckner H. Recreation and collaboration within the Expanded Chronic Care Model: working towards social transformation. Health Promotion International. 2020;35(6):1531–1542. https://doi.org/10.1093/heapro/daz134.
5. Whitney SL, Sparto PJ, Alahmari K, Redfern MS, Furman JM. The use of virtual reality for people with balance and vestibular disorders: The Pittsburgh experience. Physical Therapy Reviewes. 2009;14(5):299-306.
6. Kim WS, Cho S, Ku J, et al. Clinical Application of Virtual Reality for Upper Limb Motor Rehabilitation in Stroke: Review of Technologies and Clinical Evidence. Journal of Clinical Medicine. 2020;9(10):3369. https://doi.org/10.3390/jcm9103369.
7. Chan MF, Giddings DR, Chandler CS, Craggs C, Plant RD, Day MC. An experimentally confirmed statistical model on arm movement. Human Movement Science. 2004;22(6):631–648. https://doi.org/10.1016/j.humov.2004.02.002.
8. Kiper P, Szczudlik A, Agostini M, et al. Virtual Reality for Upper Limb Rehabilitation in Subacute and Chronic Stroke: A Randomized Controlled Trial. Archives of physical medicine and rehabilitation. 2018;99(5):834–842.e4. https://doi.org/10.1016/j.apmr.2018.01.023.
9. Furmanek MP, Schettino LF, Yarossi M, Kirkman S, Adamovich SV, Tunik E. Coordination of reach-to-grasp in physical and haptic-free virtual environments. Journal of neuroengineering and rehabilitation. 2019;16(1):78. https://doi.org/10.1186/s12984-019-0525-9.
10. Colomer C, Llorens R, Noé E, Alcañiz M. Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke. Journal of neuroengineering and rehabilitation. 2016;13(1):45. https://doi.org/10.1186/s12984-016-0153-6.
11. Aşkın A, Atar E, Koçyiğit H, Tosun A. Effects of Kinect-based virtual reality game training on upper extremity motor recovery in chronic stroke. Somatosensory & motor research. 2018;35(1):25–32. https://doi.org/10.1080/08990220.2018.1444599.
12. Rose FD, Brooks BM, Attree EA, et al. A preliminary investigation into the use of virtual environments in memory retraining after vascular brain injury: indications for future strategy? Disability and Rehabilitation. 1999;21(12):548–554. https://doi.org/10.1080/096382899297206.
13. Paternostro-Sluga T, Grim-Stieger M, Posch M, et al. Reliability and validity of the Medical Research Council (MRC) scale and a modified scale for testing muscle strength in patients with radial palsy. Journal of rehabilitation medicine. 2008;40(8):665–671. https://doi.org/10.2340/16501977-0235.
14. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. Journal of psychiatric research. 1975;12(3):189–198. https://doi.org/10.1016/0022-3956(75)90026-6.
15. Kopp B, Kunkel A, Flor H, et al. The Arm Motor Ability Test: reliability, validity, and sensitivity to change of an instrument for assessing disabilities in activities of daily living. Archives of physical medicine and rehabilitation. 1997;78(6):615–620. https://doi.org/10.1016/s0003-9993(97)90427-5.
16. Statistical Solutions. nQuery Advisor. UK. 2001. https://www.statsols.com/clinical-trial-design-solutions?hsLang=en-us
17. Mahoney FI, Barthel DW. Functional evaluation: The barthel index. Maryland state medical journal. 1965;14:61–65.
18. Stroke Centre. 2020. http://strokecenter.org/trials/scales/barthel.html. Accessed April 04, 2022.
19. Lyle RC. A performance test for assessment of upper limb function in physical rehabilitation treatment and research. International Journal of Rehabilitation and Research. 1981;4:483-49.
20. Grattan ES, Velozo CA, Skidmore ER, Page SJ, Woodbury ML. Interpreting Action Research Arm Test Assessment Scores to Plan Treatment. OTJR: occupation, participation and health. 2019;39(1):64–73. https://doi.org/10.1177/1539449218757740.
21. Amano S, Umeji A, Uchita A, et al. Clinimetric properties of the action research arm test for the assessment of arm activity in hemiparetic patients after stroke. Topics in stroke rehabilitation. 2020;27(2):127–136. https://doi.org/10.1080/10749357.2019.1667656
22. Platz T, Pinkowski C, van Wijck F, Kim IH, di Bella P, Johnson G. Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer Test, Action Research Arm Test and Box and Block Test: a multicentre study. Clinical Rehabilitation. 2005;19(4):404–411. https://doi.org/10.1191/0269215505cr832oa.
23. Urbaniak GC, Plous S. Research Randomizer (Version 4.0) 2013. http://www.randomizer.org/ Retrieved on June 22, 2022
24. Wolf SL, Catlin PA, Ellis M, Archer AL, Morgan B, Piacentino A. Assessing Wolf motor function test as outcome measure for research in patients after stroke. Stroke. 2001;32(7):1635–1639. https://doi.org/10.1161/01.str.32.7.1635.
25. Canny ML, Thompson JM, Wheeler MJ. Reliability of the box and block test of manual dexterity for use with patients with fibromyalgia. The American journal of occupational therapy: official publication of the American Occupational Therapy Association. 2009;63(4):506–510. https://doi.org/10.5014/ajot.63.4.506.
26. Kuchera B. Oculus Quest 2 review: smaller, cheaper, better. Polygon. 2020 https://www.polygon.com/reviews/2020/9/16/21437762/oculus-quest-2-review-virtual-reality-vr-facebook-oculus-power-resolution-tracking. Accessed March 04, 2022.