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Article type: Research Article
Authors: Choi, Yoon-Heea; b | Ku, Jeonghunc | Lim, Hyunmic | Kim, Yeo Hyunga | Paik, Nam-Jonga; *
Affiliations: [a] Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea | [b] Department of Physical Medicine and Rehabilitation, Soonchunhyang University College of Medicine, Soonchunhyang University Hospital, Seoul, South Korea | [c] Department of Biomedical Engineering, Keimyung University, Daegu, South Korea
Correspondence: [*] Corresponding author: Nam-Jong Paik, MD, PhD, Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea. Tel.: +82 31 787 7731; Fax: +82 31 787 4056; E-mail: njpaik@snu.ac.kr.
Abstract: Background: Virtual reality (VR) has the potential to provide intensive, repetitive, and task-oriented training, and game-based therapy can enhance patients’ motivation and enjoyment. Objective: The objective of the present study was to develop a mobile game-based upper extremity VR program for patients who have experienced stroke, and to evaluate the feasibility and effectiveness of the program. Methods: This randomized, double-blind, controlled trial included 24 patients with ischemic stroke. The intervention group (n = 12) received 30 min of conventional occupational therapy (OT) and 30 min of the mobile upper extremity rehabilitation program using a smartphone and a tablet PC (MoU-Rehab). The controls (n = 12) received conventional OT alone for 1 h per day. Rehabilitation consisted of 10 sessions of therapy, 5 days per week, for 2 weeks. The outcome measures (Fugl−Meyer Assessment of the upper extremity [FMA-UE], Brunnström stage [B-stage] for the arm and the hand, manual muscle testing [MMT], modified Barthel index [MBI], EuroQol-5 Dimension [EQ-5D], and Beck Depression Inventory [BDI]) were assessed at the beginning and end of treatment, and at 1 month. User satisfaction was evaluated by a questionnaire. Results: A greater improvement in the FMA-UE, B-stage, and MMT was found after treatment with the MoU-Rehab than with conventional therapy. The extent of improvements in the MBI, EQ-5D, and BDI was not significantly different between the two groups. Patients in the experimental group completed the 2-weeks treatment without adverse effects, and they were generally satisfied with MoU-Rehab. Conclusion: This mobile game-based VR rehabilitation program appears to be feasible and effective for promoting upper limb recovery after ischemic stroke.
Keywords: Ischemic stroke, m-health, stroke, rehabilitation, upper limb dysfunction
DOI: 10.3233/RNN-150626
Journal: Restorative Neurology and Neuroscience, vol. 34, no. 3, pp. 455-463, 2016
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