Virtual Reality Training for Upper Extremity in Subacute Stroke (VIRTUES): A multicenter RCT

Area of Science:

• Neurorehabilitation
• Robotics and Virtual Reality in Medicine
• Stroke Recovery

Background:

• Stroke is a leading cause of long-term disability, often resulting in upper extremity motor impairment.
• Virtual Reality (VR) offers immersive and potentially motivating environments for rehabilitation.
• Conventional Training (CT) remains a standard approach for post-stroke motor recovery.

Purpose of the Study:

• To compare the effectiveness of upper extremity VR rehabilitation training against time-matched CT.
• To evaluate VR and CT as adjuncts to standard rehabilitation in the subacute phase post-stroke.
• To assess motor function recovery using validated outcome measures.

Main Methods:

• A randomized, controlled, single-blind phase III multicenter trial involving 120 participants within 12 weeks post-stroke.
• Participants were randomized to either VR or CT, stratified by hand paresis severity.
• Training consisted of sixteen 60-minute sessions over 4 weeks, with assessments at baseline, post-intervention, and 3-month follow-up.

Main Results:

• No significant between-group differences were observed in upper extremity motor function improvement.
• Both VR and CT groups showed similar gains in the Action Research Arm Test (ARAT) scores post-intervention and at follow-up.
• Subgroup analysis revealed comparable improvements in both mild-to-moderate and severe paresis groups.

Conclusions:

• Additional upper extremity VR training is not superior to, but equally effective as, additional CT in the subacute phase after stroke.
• VR presents a viable and potentially more engaging alternative training method.
• Both VR and CT can effectively supplement standard rehabilitation protocols for stroke patients.