EFFECTS OF THREE-WEEK VIRTUAL REALITY GAME TRAINING ON UPPER-LIMB MOTOR RECOVERY AMONG STROKE SURVIVORS: A PILOT RANDOMIZED CONTROL TRIAL

Purpose: This study aimed to examine the effect of VR gaming on motor function and Activities of Daily Living (ADLs) of the affected upper limb of stroke survivors.

Methods: Thirty Nigerian stroke survivors with ages ranging from 30 to 85 were randomised into VR and Conventional Physiotherapy (CPT) groups. The CPT group received Conventional in-patient Rehabilitation (CiR) only. On the other hand, the VR group were involved in twice-weekly VR game sessions using the Fit XR™ gaming app on the Oculus Quest 2.0 system, in addition to CiR. All interventions were conducted for three weeks, and outcomes were assessed at baseline and the end of the study using the Fugl-Meyer Assessment of Upper Extremity (FMA-UE), Upper Extremity Functional Index (UEFI), Wolf Motor Function Test (WMFT) and Medical Research Council Scale. Paired t-test was used for within-group comparison. Independent t-test was used to compare effects between groups. Alpha level was set at p0.05.

Results: The mean ages of participants were 64.93 ± 11.20 years, and 61.20 ± 12.77 years for the VR and CPT groups respectively. Within the VR group there were statistically significant differences in effects on motor function (p0.001), coordination (p0.001), hand function (p=0.002), grasp (p=0.005), joint pain (p = 0.029), muscle strength  (p0.001), grip strength  (p0.001),  alongside WMFT  (p0.001), and UEFI  (p0.001), ADL measures. CiR alone also had significant effects on motor function (p =0.009), hand function (p=0.047), grasp (p=0.001), muscle strength (p=0.002), grip strength (p =0.001), and WMFT outcomes (p=0.001). There were significant between-group differences on joint pain (p=0.038), muscle strength (p0.001), and UEFI outcomes (p=0.010) after the interventions. However, no significant statistical differences were found in motor function (p=0.481), hand function (p=0.185), grasp (p=0.100), coordination (p=1.000), sensation (p=0.152), passive joint motion (p=0.203), grip strength (p=0.281), and WMFT outcomes (p=0.056).

Conclusions: Virtual reality gaming was beneficial in improving muscle strength and reducing joint pain which translated to improved motor function and performances in ADLs.

Implication: VR gaming is a valuable adjunctive therapy in stroke rehabilitation, potentially leading to better outcomes for stroke survivors in LMICs like Nigeria. It may also serve as an instrumental tool in planning home program routines, in turn reducing healthcare dependency.