Role of Fully-Immersive Virtual Reality for Paretic Arm Recovery in Stroke Rehabilitation

Seyoung ShinGyoseok HwangYubin KimEunYoung ParkDong Rae ChoHongseok BaekMinYoung Kim^*

• CHA University Bundang Medical Center, Seongnam-si, Republic of Korea

Introduction: Rehabilitative training using fully immersive virtual reality (VR) has emerged as a promising method for improving motor function in patients with stroke. We evaluated the efficacy of VR technology as an adjunctive therapy in stroke rehabilitation. Methods: A VR program was designed by the research team to facilitate the movement of the paralyzed arm, and participation was offered to inpatients on a voluntary basis at a university-affiliated Rehabilitation Medicine Center. A retrospective analysis was conducted on patients with subacute stroke who were selected without bias between November 2015 and January 2020. Clinical outcomes were compared between the VR-received (n=30) and the control groups (n=14), which received only conventional rehabilitation. Outcome measures included the Fugl–Meyer Assessment for Upper Extremity, modified Barthel Index, Functional Independence Measure, Mini-Mental Status Examination, and Motor-Free Visual Perception Test, performed before and after each treatment, and changes in the scores between the two time points were measured. A subgroup analysis was conducted according to the number of VR interventions in the VR group. Multivariate regression was used to control for confounding variables. Results: There were no significant differences in baseline demographic characteristics and functional abilities between the two groups, except for a longer interval between the pre-and post-assessments in the control group (P<0.01). The VR group showed a significantly greater improvement in Fugl– Meyer Assessment for Upper Extremity scores on the affected side than the control group did (P=0.01). Multivariate analysis identified VR intervention as an independent predictor of motor improvement (β = 15.78), whereas delayed rehabilitation onset was negatively associated with recovery (β = -0.83). Conclusions: In this case-control study, the findings suggest that incorporating fully immersive VR-based training in rehabilitation may enhance upper limb function recovery in patients with stroke in the subacute phase. Further randomized controlled studies are required to confirm these findings.