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Published on: May 16, 2025
Immersive virtual reality-based rehabilitation for subacute stroke: a randomized controlled trial
Qianqian Huang1,2, Xixi Jiang1,2, Yun Jin1,2
1Department of Rehabilitation Medicine, Rehabilitation Medicine Center, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China.
Immersive virtual reality (VR) therapy significantly enhances upper extremity (UE) function in stroke survivors compared to conventional care. This VR rehabilitation also correlates with measurable changes in brain functional connectivity, offering a promising new recovery method.
Area of Science:
- Neurorehabilitation
- Stroke recovery
- Virtual reality applications in medicine
Background:
- Limited effective treatments exist for improving upper extremity (UE) function post-stroke.
- Immersive virtual reality (imVR) presents a novel and promising strategy for stroke UE recovery.
- ClinicalTrials.gov identifier: NCT03086889.
Purpose of the Study:
- To assess the efficacy of imVR-based UE rehabilitation in augmenting conventional treatment for stroke patients.
- To explore changes in brain functional connectivity (FC) associated with imVR-based rehabilitation.
Main Methods:
- A parallel-group randomized controlled trial involving 40 subjects (imVR group vs. Control group).
- Intervention duration: 3 weeks, 5 times per week, with the imVR group receiving both imVR and conventional rehabilitation.
- Primary outcome: Fugl-Meyer assessment's upper extremity subscale (FMA-UE); Secondary outcome: Barthel Index (BI). Analysis included intention-to-treat (ITT) and per-protocol (PP) assessments using ANCOVA.
Main Results:
- Both ITT and PP analyses confirmed imVR rehabilitation's effectiveness.
- The imVR group showed significantly greater FMA-UE scores post-intervention (P=0.019) and at follow-up (P=0.020) compared to the Control group.
- Improvements in motor function correlated with changes in brain FC within the premotor cortex, dorsolateral prefrontal cortex, visual region, and middle frontal gyrus.
Conclusions:
- ImVR-based rehabilitation, when added to standard care, effectively improves UE functional recovery in subacute stroke patients.
- These functional improvements are linked to distinct changes in brain connectivity at different post-stroke time points.
- The study provides evidence for imVR as a promising new stroke rehabilitation method with potential benefits for future patients.
