Increasing upper limb training intensity in chronic stroke using embodied virtual reality: a pilot study.

No control group and only 10 participants, so this cannot show that VR is better than usual care or that it caused recovery. Participants continued usual therapy and daily activities, and one received Botox during the treatment, so the effect of VR alone cannot be separated from other treatments or time. All were chronic outpatients with minor-to-moderate stroke and enough arm movement for the tasks; severe cognitive impairment and epilepsy risk were excluded, so results may not apply to more severe or medically complex patients. Baseline functional independence was already high, median 121.5 of 126, leaving little room for FIM to improve. Session length and frequency were shaped by outpatient transport and therapist availability, and prior physical activity was not measured. The authors state the study is underpowered and cannot provide evidence on therapy effectiveness.

Do not read this as proof that VR upper-limb training improves stroke recovery. It was a 10-person pilot with no control group, and participants also continued usual therapy, so the VR contribution cannot be separated from usual care, time, or other factors such as Botox in one participant.