Stroke patients may see improved movement and use of their respective paretic limbs after introduction to virtual reality-based therapy, according to a small pilot study led by Belén Rubio of the Laboratory of Synthetic, Perceptive, Emotive and Cognitive Systems at Universitat Pompeu Fabra in Spain.
This discovery can be translated to work in your physical therapy jobs or travel nursing jobs.
Study specifics
The researchers studied 20 hemiparetic stroke patients to see if acquired nonuse could be overcome by reinforcement-based training strategies in a virtual environment.
Hemiparesis is a common result of a stroke due to a loss of neural tissue that limits cognitive and motor functions. Patients often overcompensate for this by using the healthy limb more than the paretic limb, even though both work. The benefits of overusing a healthy limb, as compared to balancing use between both healthy and paretic limbs, are short term. The long term-effects are additional loss of neural and behavioral functions of the paretic limb, or “acquired nonuse.”
With a Rehabilitation Gaming System linked to a Microsoft Kinect sensor, patients controlled an avatar that synchronized to their own movements. Specifically, the gaming system allows the user to control a virtual body that is viewed from a first-person perspective on a computer screen. The participant’s movements are captured and transmitted to the screen by the Microsoft sensor.
The study was divided into three sessions: baseline, intervention and washout. During the intervention session, researchers represented patients’ paretic limb movements in the virtual simulation as more accurate than in reality. This, in a sense, “tricked” patients into believing their paretic limb was performing at a higher level than it was.
“Surprisingly, only 10 minutes of enhancement was enough to induce significant changes in the amount of spontaneous use of the affected limb,” Rubio said in a press release. “This therapy could create a virtuous circle of recovery, in which positive feedback, spontaneous arm use and motor performance can reinforce each other. Engaging patients in this ongoing cycle of spontaneous arm use, training and learning could produce a remarkable impact on their recovery process.”
Prior to the virtual reality enhancement, patients averaged a 35 percent chance of using their paretic arm to reach for an item in front of them. After the enhancement, the patients averaged a 50 percent chance of using their paretic arm. This is the same probability of use for a person who has healthy function of both arms.
Study outcome
The findings, published by the Journal of Neuroengineering and Rehabilitation, show that increased movement of a paretic limb in a virtual environment promotes the use of the paretic limb in stroke patients. In turn, the researchers suggest implementing reinforcement-based therapies as a possible effective approach for offsetting learned nonuse of limbs and increasing real-world motor performance.
Paul Verschure, an author of the study, told BBC News that a long-term follow-up has been designed to oversee the effects of the study in the everyday lives of patients.