The effects of the virtual reality on upper extremity functions in stroke patients

Stroke rehabilitation, needed to develope new approaches, to help the individual gain the highest level of functional independence. These have to activate brain plasticity and reorganization of the neural system. Virtual Reality (VR) game system is one these approaches, that provides to use hemiplegic upper extremity for stroke patients. In stroke rehabilitation has limited evidence for using the VR game system. The aim of our study is to evaluate the effect of the Microsoft Xbox 360 Kinect™ video game system on upper limb motor function for the patients with subacute stroke. The participants of this study are 42 stroke patients (21 VR group, 21 Control group) who were rehabilitated in Başkent University Physical Medicine and Rehabilitation clinic between the dates 25.04.2014 and 30.03.2015. Totally 35 patients (19 VR group, 16 Control group) have been completed the study. The patients in both groups received 60-120 minutes of conventional stroke rehabilitation program for upper extremity, 5 times per week for 4 weeks. VR group patients additionally received Dr. Kawashima's Body and Brain Exercises Xbox 360 Kinect™ video game system 30-60 minutes per day. The patients were evaluated at the beginning of the rehabilitation program (pre-treatment) and at the end of 4 weeks (post treatment). Box&Block Test (BBT), Functional independence measure self care score (FIM), Brunnstorm Recovery Stage(BRS) and Fugl-Meyer upper extremity motor function scale were used. There were no significant differences between groups in any of the demographic characteristics. Before the treatment, there were no significant differences between the groups for BRS, BBT and FIM self care score (p=0.19, p=0.31, p=0.72, p=0.40), but FM scale values of SG group were significantly higher compared to control group (p=0.04). After the treatment, BMS, BBT and FM scale values of SG group were significantly higher compared to control group (p=0.03, p=0.04, p=0.04). However, FIM self care and FM gain scores were similar between the SG group and control group (p=0.95, p=0.057). In conclusion, it was determined that Xbox 360 Kinect™ Virtual Reality video game system in addition to conventional therapy program in upper extremity rehabilitation has supplemental benefit for stroke patients in improving upper extremity motor function. Xbox 360 Kinect™ VR video game system in order to enter the routine practice of the stroke rehabilitation; for finding answers the questions like which games, how long period of time and intensity for using this VR system we need randomized controlled clinical trials with longer follow up period.