Use of client-centered virtual reality in rehabilitation after stroke: a feasibility study

• Published in: Arquivos de neuro-psiquiatria Vol. 77; no. 9; pp. 622 - 631
• Main Authors: Aramaki, Alberto Luiz, Sampaio, Rosana Ferreira, Cavalcanti, Alessandra, Dutra, Fabiana Caetano Martins Silva E
• Format: Journal Article
• Language: English
• Published: Brazil Arquivos de Neuro-Psiquiatria 01.09.2019; Academia Brasileira de Neurologia - ABNEURO; Academia Brasileira de Neurologia (ABNEURO)
• Subjects: acidente vascular cerebral; Activities of Daily Living; Adult; assistência centrada no paciente; Computer & video games; Computer applications; Disability Evaluation; Feasibility Studies; Female; Humans; jogos de vídeo; Male; Middle Aged; NEUROSCIENCES; Participation; PSYCHIATRY; Reabilitação; Recovery of Function; Rehabilitation; Reproducibility of Results; Self Report; Social Participation; Statistical analysis; Stroke; Stroke Rehabilitation - methods; terapia de exposição à realidade virtual; Time Factors; Treatment Outcome; Video Games; Virtual reality; Virtual Reality Exposure Therapy - methods; Young Adult; acidente vascular cerebral; patient-centered care; jogos de vídeo; assistência centrada no paciente; Reabilitação; virtual reality exposure therapy; Rehabilitation; stroke; terapia de exposição à realidade virtual; video games
• ISSN: 0004-282X; 1678-4227; 1678-4227
• DOI: 10.1590/0004-282X20190103

Patient-centered virtual reality (VR) programs could assist in the functional recovery of people after a stroke. OBJECTIVES To analyze the feasibility of a rehabilitation protocol using client-centered VR and to evaluate changes in occupational performance and social participation. METHODS This was a mixed methods study. Ten subacute and chronic stroke patients participated in the rehabilitation program using games in non-immersive VR for 40 minutes/day, three days/week, for 12 weeks. Sociodemographic information was collected and the outcome variables included were the Canadian Occupational Performance Measure (COPM) and the Participation Scale. A field diary was used to record the frequency of attendance and adherence of participants and an interview was conducted at the end of program. RESULTS There were significant and clinically-relevant statistical improvements in the COPM performance score (p < 0.001; CI = 1.29 - 4.858) and in the COPM satisfaction score (p < 0.001; CI = 1.37 - 5.124), with a difference greater than 4.28 points for performance and 4.58 points for satisfaction. The change in the scores for participation was statistically significant (p = 0.046), but there was no clinical improvement (dcohen = -0.596, CI = -1.862 - 0.671). The majority of participants reported more than 75% consecutive attendance of sessions and there was 100% adherence to the program. In the interviews, the participants described their post-stroke difficulties; how the video game motivated their engagement in rehabilitation; and the improvement of occupational performance and social participation after participating in the program. CONCLUSIONS VR is a viable tool for the rehabilitation of stroke patients with functional gains, mainly regarding occupational performance and performance satisfaction.