Non-immersive Virtual Reality for Fine Motor Rehabilitation of Functional Activities in Individuals with Chronic Stroke: A Review

Abstract

More than two thirds of the individuals who have strokes are over the age of 65. Therefore, as the global population continues to age, the risk of stroke is expected to increase substantially. Virtual reality (VR) is an emerging therapy that holds promise for the rehabilitation of patients with chronic stroke conditions. VR is an interactive, computer-based simulation of real life tasks, occurring in real time. The aim of this review was to explore whether non-immersive VR could be used to effectively improve fine motor function of the affected upper extremity in patients with chronic stroke. Ten studies examining non-immersive VR for the purpose of chronic stroke rehabilitation were included for review. Studies utilized a variety of VR-based interventions, reporting trends toward improvement on nearly all outcome measures. Results were examined at the levels of “body structure and function” and “activity” according to the International Classification of Functioning. Across the studies, significant improvements were reported for the Jebsen Test of Hand Function, the Box and Block Test, participants’ finger fractionation, finger tracking measures, and time from peak hand velocity to movement of an object. However, considerable variability in participants’ recovery rates of fine motor function across the studies suggests that the results should be interpreted with caution. More research using randomized controlled trial designs will clarify evidence surrounding the amount of improvement that can be experienced with non-immersive VR-based interventions. This review provides justification for continued investigation within the field of motor skill recovery in patients with chronic stroke.