Amin Faisal, Waris Asim, Syed Sania, Amjad Imran, Umar Muhammad, Iqbal Javaid, Omer Gilani Syed
IEEE Trans Neural Syst Rehabil Eng. 2024;32:2060-2069. doi: 10.1109/TNSRE.2024.3405852. Epub 2024 May 30.
Stroke rehabilitation faces challenges in attaining enduring improvements in hand motor function and is frequently constrained by interventional limitations. This research aims to present an innovative approach to the integration of cognitive engagement within visual feedback incorporated into fully immersive virtual reality (VR) based games to achieve enduring improvements. These innovative aspects of interaction provide more functional advantages beyond motivation to efficiently execute repeatedly hand motor tasks. The effectiveness of virtual reality games incorporated with innovative aspects has been investigated for improvements in hand motor functions. A randomized controlled trial was conducted, a total of (n=56) subacute stroke patients were assessed for eligibility and (n=52) patients fulfilled the inclusion criteria. (n=26) patients were assigned to the experimental group and (n=26) patients were assigned to the control group. VR intervention involves four VR based games, developed based on hand movements including flexion/extension, close/open, supination/pronation and pinch. All patients got therapy of 24 sessions, lasting 4 days/week for a total of 6 weeks. Five clinical outcome measures were Fugl- Meyer Assessment-Upper Extremity, Action Research Arm Test, Box and Block Test, Modified Barthel Index, and Stroke-Specific Quality of Life were assessed to evaluate patients' performance. Results revealed that after therapy there was significant improvement between the groups (p<0.05) and within groups (p<0.05) in all assessment weeks in all clinical outcome measures however, improvement was observed significantly greater in the experimental group due to fully immersive VR-based games. Results indicated that cognitive engagement within visual feedback incorporated in VR-based hand games effectively improved hand motor functions.
中风康复在实现手部运动功能的持久改善方面面临挑战，并且常常受到干预限制的制约。本研究旨在提出一种创新方法，将认知参与整合到基于完全沉浸式虚拟现实（VR）游戏的视觉反馈中，以实现持久改善。这些创新的交互方面除了能激发动力以高效重复执行手部运动任务外，还提供了更多功能优势。已对融入创新方面的虚拟现实游戏对手部运动功能改善的有效性进行了研究。进行了一项随机对照试验，共有（n = 56）名亚急性中风患者接受资格评估，（n = 52）名患者符合纳入标准。（n = 26）名患者被分配到实验组，（n = 26）名患者被分配到对照组。VR干预包括四款基于VR的游戏，这些游戏基于手部动作开发，包括屈伸、开合、旋前/旋后和捏取。所有患者均接受24次治疗，每周4天，共6周。采用Fugl - Meyer上肢评估、动作研究臂测试、箱块测试、改良Barthel指数和中风特异性生活质量这五项临床结局指标来评估患者的表现。结果显示，治疗后，在所有临床结局指标的所有评估周中，组间（p < 0.05）和组内（p < 0.05）均有显著改善，然而，由于基于完全沉浸式VR的游戏，实验组的改善明显更大。结果表明，基于VR的手部游戏中融入视觉反馈的认知参与有效改善了手部运动功能。
