Elements virtual rehabilitation improves motor, cognitive, and functional outcomes in adult stroke: evidence from a randomized controlled pilot study

Journal of NeuroEngineering and Rehabilitation

Peter H. Wilson¹  Jeffrey M. Rogers²  Bert Steenbergen³  Sandy Middleton⁴  Jonathan Duckworth⁵ 

[1] 0000 0001 2194 1270, grid.411958.0, Centre for Disability and Development Research (CeDDR) and School of Behavioural and Health Science, Australian Catholic University, Melbourne, VIC, Australia;0000 0004 1936 834X, grid.1013.3, The University of Sydney, Faculty of Health Sciences, Sydney, NSW, Australia;0000000122931605, grid.5590.9, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands;Nursing Research Institute, St Vincent’s Health Australia and Australian Catholic University, Sydney, NSW, Australia;School of Design, RMIT, Melbourne, VIC, Australia;

关键词: Cognition;    Motor activity;    Rehabilitation;    Stroke;    Upper extremity;    Virtual reality;   

DOI  :  10.1186/s12984-019-0531-y

来源: publisher

【 摘 要 】

BackgroundVirtual reality technologies show potential as effective rehabilitation tools following neuro-trauma. In particular, the Elements system, involving customized surface computing and tangible interfaces, produces strong treatment effects for upper-limb and cognitive function following traumatic brain injury. The present study evaluated the efficacy of Elements as a virtual rehabilitation approach for stroke survivors.MethodsTwenty-one adults (42–94 years old) with sub-acute stroke were randomized to four weeks of Elements virtual rehabilitation (three weekly 30–40 min sessions) combined with treatment as usual (conventional occupational and physiotherapy) or to treatment as usual alone. Upper-limb skill (Box and Blocks Test), cognition (Montreal Cognitive Assessment and selected CogState subtests), and everyday participation (Neurobehavioral Functioning Inventory) were examined before and after inpatient training, and one-month later.ResultsEffect sizes for the experimental group (d = 1.05–2.51) were larger compared with controls (d = 0.11–0.86), with Elements training showing statistically greater improvements in motor function of the most affected hand (p = 0.008), and general intellectual status and executive function (p ≤ 0.001). Proportional recovery was two- to three-fold greater than control participants, with superior transfer to everyday motor, cognitive, and communication behaviors. All gains were maintained at follow-up.ConclusionA course of Elements virtual rehabilitation using goal-directed and exploratory upper-limb movement tasks facilitates both motor and cognitive recovery after stroke. The magnitude of training effects, maintenance of gains at follow-up, and generalization to daily activities provide compelling preliminary evidence of the power of virtual rehabilitation when applied in a targeted and principled manner.Trial registrationthis pilot study was not registered.

【 授权许可】

CC BY