Adaptive conjunctive cognitive training (ACCT) in virtual reality for chronic stroke patients: a randomized controlled pilot trial.
Martina Maier, Belén Rubio Ballester, Nuria Leiva Bañuelos and 2 others
PMID 32143674WHAT IT FOUND
A VR cognitive training program showed within-group improvements in attention and spatial awareness for chronic stroke patients.
However, there was no significant difference compared to home-based paper-and-pencil exercises, and the authors state they cannot claim a rehabilitation effect.
Key findings
01Patients in the VR group showed significant improvements over time in attention and spatial awareness scores compared to their own baseline.
02There were no significant differences in cognitive improvements between the VR group and the control group doing home exercises.
03The authors explicitly state that due to the small sample size and multiple testing, they cannot claim any rehabilitation effect.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was a pilot with a very small sample size (30 valid cases analyzed), which the authors admit makes the results potentially spurious. Participants and the experimenter were not blinded to the group allocation, which could influence performance and reporting. The control group performed exercises at home while the experimental group went to the hospital, introducing differences in location and potential social interaction that were not controlled for. Adherence to the home-based control intervention was not monitored during the study, only self-reported after completion. The depression subgroup analysis was affected by one patient with a large improvement, and excluding this patient changed the significance of the depression findings.
Declared interests
The study was funded by the Ministerio de Economia y Empresa, the European Research Council, H2020 Future and Emerging Technologies, and EIT Health (RGS@Home) under H2020.
The easy way to misread this
Do not interpret the within-group improvements in the VR arm as evidence that it is superior to standard care. The between-group analysis showed no significant difference compared to the control group, and the authors explicitly state they cannot claim a rehabilitation effect.