Virtual reality rehabilitation is safe and feasible for upper extremity recovery after subacute ischemic stroke

1. Non-immersive virtual reality rehabilitation was feasible and safe but did not demonstrate superiority over equally intensive conventional physiotherapy for upper extremity recovery after subacute ischemic stroke.

2. Both rehabilitation approaches resulted in clinically meaningful improvements in motor function, activities of daily living, and quality of life.

Evidence Rating Level: 1 (Excellent) 

Upper extremity impairment persists in 30–60% of stroke survivors at six months and significantly affects independence and quality of life. Virtual reality-based rehabilitation has been proposed as an engaging, high-intensity alternative to conventional physiotherapy, but evidence regarding its superiority remains conflicting. This multicenter, open-label, parallel-group randomized controlled trial evaluated the feasibility and efficacy of a non-immersive virtual reality-based comprehensive rehabilitation gaming system in comparison with equally intensive conventional physiotherapy in subacute ischemic stroke patients. Sixty first-ever ischemic stroke patients (1–6 months post-stroke) with mild-to-moderate upper extremity impairment were randomized to 12 weeks of therapy (45 minutes, three times weekly). The primary feasibility outcome was treatment compliance. Primary efficacy outcomes were motor function assessed by the Fugl-Meyer Assessment and Wolf Motor Function Test. Secondary outcomes included the Barthel Index and SF-36. Treatment adherence was similar between groups. Both interventions produced significant within-group improvements in motor function, activities of daily living, and quality of life. However, no statistically significant between-group differences were observed for any primary or secondary outcomes. No serious intervention-related adverse events occurred. The non-immersive virtual reality system was feasible, safe, and as effective as conventional physiotherapy, but not superior. Interpretation is limited by early trial termination and inadequate sample size.

Click here to read this study in BMJ Open

Image: PD

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