PTOTPilotAmerican journal of physical medicine & rehabilitation2019

Immersive Virtual Reality Mirror Therapy for Upper Limb Recovery After Stroke: A Pilot Study.

Lynne M Weber, Dawn M Nilsen, Glen Gillen and 2 others

PMID 30964752

WHAT IT FOUND

Ten chronic stroke survivors tolerated immersive virtual reality mirror therapy without adverse events or significant cybersickness.

Motor scores improved slightly but not significantly. The study confirms safety and feasibility but does not show the treatment works.

Key findings

01Ten of eleven participants completed the full twelve-session protocol with no adverse events and little to no cybersickness.

02Motor function scores showed a small improvement that did not reach statistical significance.

03Participants rated the system's usability as above average, with a mean score of 76 on a scale where 68 is the threshold.

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 was a pilot with a very small sample size, so it was not powered to detect significant differences in motor outcomes. Participants were screened for motion sickness susceptibility and had unusually low scores, which may mean the tolerability results do not apply to the general stroke population. The duration of therapy was six hours total, which is less than the fifteen hours often cited as necessary for significant VR benefits. The study included patients with cognitive impairments, which may have affected their ability to engage fully with the therapy, though all participants were able to use the system.

Declared interests

The software was developed by Realiteer, and the study was supported by the National Institutes of Health. The authors state that the gaming environments were engineered by Realiteer.

The easy way to misread this

Do not interpret the slight numerical increase in motor scores as evidence that the therapy works. The changes were not statistically significant, and the study was designed to test safety and feasibility, not efficacy.

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