Effect of Virtual Reality Combined with Modified Constraint-Induced Movement Therapy on Chronic Stroke Survivors

Abstract

<h3>Research Objectives</h3> To evaluate the effect of virtual reality combined with modified constraint-induced movement therapy-based upper limb training on chronic stroke survivors. <h3>Design</h3> Intervention. Randomized control trial, baseline two and four-week intervention. <h3>Setting</h3> In the Hospital setting outpatients. <h3>Participants</h3> Twenty-six patients both males and females with chronic stroke for more than 6 months and dysfunction in the upper limb were included in the study. The age range between 20 to 45 years was included. Convenient sampling is used for the selection procedure. <h3>Interventions</h3> Virtual reality Group: Treatment for 20 min 3 sessions per week for 4 weeks along with the conventional therapy. The VR protocol included using a VR headset and the games. In the Rally ball game, balls approaching the player from multiple angles are hit from a chair. The Reflex Ridge game involves hitting, and grasping obstacles while sitting in a chair. The patient played each game for 10-mins per session. Conventional therapy includes passive stretching, repetitive task-specific activities, passive, active-assisted and active ROM exercises. Virtual reality combined with m-CIMT Group: Treatment for 20 min 3 sessions per week for 4 weeks along with the conventional therapy. The unaffected hand of the participant was restrained and then the same VR treatment (as above) was given to the participants. <h3>Main Outcome Measures</h3> Wolf motor function test, DASH Questionnaire, Modified Ashworth Scale, and Box & Block test. <h3>Results</h3> The treatment group significantly improved from the control group. Repeated measure ANOVA showed significant improvement for all the outcome measures (p< 0.005) within the 2 groups. The Independent t-test shows a significant difference in Gross motor function, patient self-report disability, and manual dexterity of upper limb (p< 0.005) and no significant difference in spasticity for MAS (p>0.005) between the groups. <h3>Conclusions</h3> Both treatment approaches in the control and Treatment groups are effective in managing motor functional status, spasticity level of the upper extremity, disability level, and manual proficiency of the upper extremity. Except for spasticity, both treatment approaches were found equally effective. <h3>Author(s) Disclosures</h3> There is no conflict of interest