Development of the Home based Virtual Rehabilitation System (HoVRS) to remotely deliver an intense and customized upper extremity training.
Qinyin Qiu, Amanda Cronce, Jigna Patel and 4 others
PMID 33228709WHAT IT FOUND
Fifteen people with chronic stroke used a home virtual reality system for three months.
Their upper limb function scores improved by an average of 5.2 points, exceeding the clinically important difference. The system was feasible, with participants averaging 13.5 hours of use and few technical issues.
Key findings
01Participants improved their Upper Extremity Fugl-Meyer Assessment scores by an average of 5.2 points, which exceeded the minimally clinically important difference.
02The system was feasible with no adverse events, and participants averaged 47.18 sessions and 13.5 hours of use over three months.
03Kinematic measures of hand opening range and accuracy predicted a substantial portion of the variability in clinical impairment scores.
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
The study had a small sample size of 15 participants and no control group, so it is impossible to determine if improvements were due to the system, natural recovery, or other factors. The system is not suitable for severely impaired patients (UEFMA < 15) who cannot move any upper extremity joints. Kinematic testing was only piloted in the last ten subjects, limiting the generalizability of those specific findings. Some participants required in-person support for positioning difficulties, which may not be scalable in all clinical settings.
Declared interests
Funding was provided by the National Institute on Disability, Independent Living, and Rehabilitation Research and the Foundation for the National Institutes of Health. No commercial conflicts of interest were declared.
The easy way to misread this
Do not interpret the 5.2-point improvement as proof that HoVRS is superior to standard care, as this was a single-group pilot study without a control condition. Natural recovery and other concurrent therapies cannot be ruled out as causes for the change.