Effectiveness of rehabilitation with virtual reality and biofeedback in recovery of hand function after stroke

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OBJECTIVE

To evaluate the effectiveness and safety of the rehabilitation glove (RG) with virtual reality (VR) and biofeedback (BFB) on recovery of the hand function in patients during the late recovery period after first hemispheric ischemic stroke (IS).

MATERIAL AND METHODS

The study was randomized and controlled. One hundred and six patients (age 58.8±4.3 years, time after stroke onset — 8.7±2.1 months) were included in the final analysis. The intervention group (n=56) received rehabilitation with RG and VR. The control group (n=50) received individualized physical therapy. The primary end points were a change in the Fugl-Meyer scale score (FMA-UE), in the Action Research Arm Test (ARAT), and in the nine holes peg test (NHPT). Secondary end points included changes in MRCS, MAS, MoCA, HADS, modified Barthel index (MBI) and quality of life (EQ-5D-5L).

RESULTS

Improvement of the motor function in the intervention group on FMA-UE scale (an increase of ≥7 points in sections A—D) was observed in 46.4% of patients, on ARAT (an increase of ≥5 points) in 53.6% of patients. There was a significant decrease in time from 36.8±6.3 sec. to 22.0±3.9 sec. on NHPT. A negative correlation was observed between the average ARAT score and anxiety (r=–0.7; p<0.05) and depression (r=–0.67; p<0.05). There was also a significant increase in EQ-5D-5L (VAS) by the end of rehabilitation in both groups with better scores in the intervention group (p=0.03).

CONCLUSION

Rehabilitation based on VR, RG, and BFB is effective in the rehabilitation of dexterous hand function in patients with first hemispheric IS.

Keywords:

stroke

rehabilitation

biofeedback

upper limb

subject-manipulative activity of the hand

digital and information and communication technologies

virtual reality

rehabilitation glove

Authors:

Kostenko E.V.

Petrova L.V.

Moscow scientific and practical center of medical rehabilitation, restorative and sports medicine of the Department of health of the city of Moscow

Martynov M.U.

Pirogov Russian National Research Medical University;
Federal Center of Brain Research and Neurotechnology of the Federal Medical Biological Agency

ORCID: 0000-0003-2797-7877

Pogonchenkova I.V.

Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine

SPIN RSCI: 8861-7367
ORCID: 0000-0001-5123-5991

Received:

07.11.2022

Accepted:

17.01.2023

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