The effect of virtual reality on left and right middle cerebral artery chronic stroke patients

Abstract

There is a considerable body of evidence around the use of non-immersive virtual reality as a therapeutic modality in stroke rehabilitation. Studies report its use in isolation, and as an adjunct to traditional physical therapy approaches. Very little is known about what effect the location of lesion and the participants’ stage of recovery can have on the efficacy of VR interventions. We present a study using non-immersive VR in two groups consisting of right-middle or left-middle cerebral artery stroke survivors in the chronic stage. Seventeen chronic stroke patients participated in this study. Participants performed 30 sessions of therapy with a Virtual Reality system supervised by a physiotherapist. A series of cognitive (MMSE), ADL (FIM and Barthel), motor (MAS, FMA upper an lower limb and MRC), gait (6MWT, Tineti), spasticity (Asworth), balance (Berg and Tinetti EQ) and depression (GDS) scales were administered to each group of right middle cerebral artery or left middle cerebral artery stroke survivors. Participants with lesions in the left middle cerebral artery had significant improvements when compared with pre- and post-scores in the Barthel, FMA lower an upper, Berg and Tinetti. Participants with right cerebral artery lesions showed significant improvements on the Barthel Index and Fugl-Meyer (lower extremity). We suggest that lateralization may be influencing the different outcomes reported between the right and left cerebral artery stroke groups in this study. We conclude that future VR motor rehabilitation strategies should consider the location of the lesion when designing interventions and call for additional research on this topic.