Virtual reality as a potential therapy in a rehabilitation sanatorium for patients after ischemic stroke: impact on quality of life and social participation - a randomized trial

Marcela Dabrowska^1*Lucie Honzikova¹Dalibor Pastucha^1,2Miroslav Janura¹Iva Fiedorova²Jana Trda³Sarka Anezka Cechova^1,2Hana Tomaskova⁴

• ¹Department of Rehabilitation and Sports Medicine, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
• ²Department of Rehabilitation and Sports Medicine, University Hospital Ostrava, Ostrava, Czechia
• ³VR LIFE s.r.o., Ostrava, Czechia
• ⁴Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Ostrava, Czechia

The aim of this study was to determine whether adding virtual reality therapy to conventional rehabilitation improves the quality of life, cognitive functions, and social participation of patients after an ischemic stroke. Design: Randomized controlled study conducted in a rehabilitation center. Participants: The experimental group with therapy in virtual reality included 25 patients (age 59.4 ± 8.9 years), and the control group with conventional therapy consisted of 25 patients (age 63.0 ± 8.8 years). Inclusion criteria for the study were: age 40-79 years, stable condition, Mini-Mental State Examination ˃25 points, intact vision, preserved grip function of the thumb and index finger of the affected limb, functional mobility according to the functional ambulatory category (FAC) 3-5, and no other neurological disease. Methods: The Mini Mental State Examination, the Barthel Index, the Extended Barthel Index, and the WHO Disability Assessment Schedule 2.0 were used to assess cognitive function, quality of life, and self-sufficiency. Based on the results of normality test were used: t-test for two samples (age, time since stroke), the chi-square test (gender), nonparametric paired Wilcoxon test and Mann-Whitney U test. Friedman analysis was used to analyze repeated measures and a post hoc test Scheffe test was used to compare differences. Statistical tests were evaluated at the 5% significance level. Results: No significant differences were found between the experimental and control groups in any of the tests applied after treatment. Significant differences emerged after treatment in all WHODAS domains studied for each group compared to the measurement before therapy. In the experimental group, the positive effects of therapy persisted one year after the end of therapy compared to the measurement before therapy. Conclusions Virtual reality has proven to be a suitable adjunct to conventional therapy for post stroke patients and offers an advantage over traditional rehabilitation methods in that it allows training in activities of daily living that are not commonly available in a hospital setting.