open access

Vol 45, No 5 (2011)
ARTYKUŁ ORYGINALNY
Submitted: 2010-08-09
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The effectiveness of reinforced feedback in virtual environment in the first 12 months after stroke

Paweł Kiper, Lamberto Piron, Andrea Turolla, Joanna Stożek, Paolo Tonin
DOI: 10.1016/S0028-3843(14)60311-X
·
Neurol Neurochir Pol 2011;45(5):436-444.

open access

Vol 45, No 5 (2011)
ARTYKUŁ ORYGINALNY
Submitted: 2010-08-09

Abstract

Background and purpose

Reinforced feedback in virtual environment (RFVE) therapy is emerging as an innovative method in rehabilitation, which may be advantageous in the treatment of the affected arm after stroke. The purpose of this study was to investigate the impact of assisted motor training in a virtual environment for the treatment of the upper extremity (UE) after stroke compared to traditional neuromotor rehabilitation (TNR), studying also if differences exist related to the type of stroke (haemorrhagic or ischaemic).

Material and methods

Eighty patients affected by a stroke (48 ischaemic and 32 haemorrhagic) that occurred at least 1 year before were enrolled. The clinical assessment comprising the Fugl-Meyer UE (F-M UE), modified Ashworth (Bohannon & Smith) and Functional Independence Measure scale (FIM) was administered before and after the treatment.

Results

A statistically significant difference between RFVE and TNR groups (Mann-Whitney U-test) was observed in the clinical outcomes of F-M UE and FIM (both p < 0.001), but not Ashworth (p = 0.053). The outcomes of F-M UE and FIM improved in the RFVE haemorrhagic group and in the TNR haemorrhagic group with a significant difference between groups (both p < 0.001), but not for Ashworth (p = 0.651). Comparing the RFVE ischaemic group to the TNR ischaemic group, statistically significant differences emerged in F-M UE (p < 0.001), FIM (p < 0.001), and Ashworth (p = 0.036).

Conclusions

The RFVE therapy in combination with TNR showed better improvements compared to the TNR treatment only. The RFVE therapy combined with the TNR treatment was more effective than the TNR double training, in both post-ischaemic and post-haemorrhagic groups. We observed improvements in both groups of patients: post-haemorrhagic and post-ischaemic stroke after RFVE training.

Abstract

Background and purpose

Reinforced feedback in virtual environment (RFVE) therapy is emerging as an innovative method in rehabilitation, which may be advantageous in the treatment of the affected arm after stroke. The purpose of this study was to investigate the impact of assisted motor training in a virtual environment for the treatment of the upper extremity (UE) after stroke compared to traditional neuromotor rehabilitation (TNR), studying also if differences exist related to the type of stroke (haemorrhagic or ischaemic).

Material and methods

Eighty patients affected by a stroke (48 ischaemic and 32 haemorrhagic) that occurred at least 1 year before were enrolled. The clinical assessment comprising the Fugl-Meyer UE (F-M UE), modified Ashworth (Bohannon & Smith) and Functional Independence Measure scale (FIM) was administered before and after the treatment.

Results

A statistically significant difference between RFVE and TNR groups (Mann-Whitney U-test) was observed in the clinical outcomes of F-M UE and FIM (both p < 0.001), but not Ashworth (p = 0.053). The outcomes of F-M UE and FIM improved in the RFVE haemorrhagic group and in the TNR haemorrhagic group with a significant difference between groups (both p < 0.001), but not for Ashworth (p = 0.651). Comparing the RFVE ischaemic group to the TNR ischaemic group, statistically significant differences emerged in F-M UE (p < 0.001), FIM (p < 0.001), and Ashworth (p = 0.036).

Conclusions

The RFVE therapy in combination with TNR showed better improvements compared to the TNR treatment only. The RFVE therapy combined with the TNR treatment was more effective than the TNR double training, in both post-ischaemic and post-haemorrhagic groups. We observed improvements in both groups of patients: post-haemorrhagic and post-ischaemic stroke after RFVE training.

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Keywords

stroke, rehabilitation, motor learning, virtual reality

About this article
Title

The effectiveness of reinforced feedback in virtual environment in the first 12 months after stroke

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 45, No 5 (2011)

Pages

436-444

DOI

10.1016/S0028-3843(14)60311-X

Bibliographic record

Neurol Neurochir Pol 2011;45(5):436-444.

Keywords

stroke
rehabilitation
motor learning
virtual reality

Authors

Paweł Kiper
Lamberto Piron
Andrea Turolla
Joanna Stożek
Paolo Tonin

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