PTOTPilotJournal of neuroengineering and rehabilitation2023

Development of a compensation-aware virtual rehabilitation system for upper extremity rehabilitation in community-dwelling older adults with stroke.

Zhiqiang Luo, Audrey Ei-Ping Lim, Ponraj Durairaj and 2 others

PMID 37127574

WHAT IT FOUND

The virtual system did not beat conventional therapy on upper-limb function after three months, but both groups improved.

It detected compensatory movements, though their counts did not fall.

Key findings

01In Study 2, total FMA-UE scores improved within both the VR and conventional groups, but the between-group difference was not significant (p = 0.231).

02The system detected compensatory movements, but the number of each compensatory movement was not significantly reduced after the VR intervention.

03During five-minute gameplay, stroke participants showed more distal compensatory movements in the first three minutes and more proximal compensatory movements after that.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

Only 15 of 18 Study 2 participants remained, and the ideal sample size stated for the motor-function aim was 136, so the study is underpowered. The study was done in one community rehabilitation center serving one community, so it may not represent older adults with stroke elsewhere. The groups differed in age at baseline (p = 0.047), which could affect interpretation of the training comparison. Kinect was less accurate than the marker-based motion capture system, so the real-time compensation detection thresholds may need adjustment. Cognitive status was not formally assessed; it was inferred from medical records. The VR system did not provide resistance training comparable to conventional strength equipment. Study 1 included only 6 stroke participants, so the compensation thresholds are preliminary.

Declared interests

Funded by the Tote Board, Singapore.

The easy way to misread this

Do not conclude that the VR system outperformed conventional therapy or reduced compensations. Both groups also continued usual rehabilitation, the between-group FMA-UE difference was not significant (p = 0.231), and the number of each compensatory movement was not significantly reduced after VR training.

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