Upper Limb Training Using Virtual Reality in Patients with Chronic Sequels of Stroke

Objectives: A large number of studies have showed a positive effect of training associated to virtual reality (VR) to improve the function of paretic upper limb (PUL) in patients with Stroke. However, there is a lack in the evidences about the transfer's potential of the gains obtained in the VR to real environment. Thus, the purpose of this study was to investigate the transfer of gains obtained through training in VR to motor function of the PUL tested in real environment (RE) in individuals with chronic sequels of stroke (CSS). Participants: Twenty-two patients with chronic sequels of stroke with a mean age of 66.4 ±7.14 years, 15 men and 7 women, mean time post stroke, 4.1± 5.14 years; 13 with left hemiparesis. Interventions: Three sessions of training in VR using four games of the Nintendo Wii (NW) that elicited large and fast upper limb movements. Main outcome measures: Goniometric measures were used as the main outcome to evaluate the transfer of gain to range of motion. As well as a computerizing test was used to evaluate the transfer of gains to movement velocity. Additionally, the scores obtained from the patients in the four games were also used as measure of learning. All measures were evaluated in two assessment time points: baseline (BA) and at end of study (EA). Results: The ANOVA for repeated measure showed that there were statistically significant improvements for all trained games and transfer tests (range of motion and movement velocity). Conclusions: Patients with CSS were able to transfer the gains obtained in the VR to motor function, specifically in range of motion and movement velocity in the PUL.