Virtual reality in the rehabilitation of the arm after hemiplegic stroke: a randomized controlled pilot study

To assess the feasibility of a trial to investigate the effectiveness of virtual reality-mediated therapy compared to conventional physiotherapy in the motor rehabilitation of the arm following stroke, and to provide data for a power analysis to determine numbers for a future main trial.

Pilot randomized controlled trial.

Clinical research facility.

Eighteen people with a first stroke, 10 males and 8 females, 7 right and 2 left side most affected. Mean time since stroke 10.8 months.

Participants were randomized to a virtual reality group or a conventional arm therapy group for nine sessions over three weeks.

The upper limb Motricity Index and the Action Research Arm Test were completed at baseline, post intervention and six weeks follow-up.

Outcome data were obtained from 95% of participants at the end of treatment and at follow-up: one participant withdrew. Compliance was high; only two people reported side-effects from virtual reality exposure. Both groups demonstrated small (7-8 points on upper limb Motricity Index and 4 points on the Action Research Arm Test), but non-significant, changes to their arm impairment and activity levels.

A randomized controlled trial of virtual reality-mediated therapy comparable to conventional therapy would be feasible, with some suggested improvements in recruitment and outcome measures. Seventy-eight participants (39 per group) would be required for a main trial.