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Virtual Immersion for Post-Stroke Hand Rehabilitation Therapy

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Abstract

Stroke is the leading cause of serious, long-term disability in the United States. Impairment of upper extremity function is a common outcome following stroke, often to the detriment of lifestyle and employment opportunities. While the upper extremity is a natural target for therapy, treatment may be hampered by limitations in baseline capability as lack of success may discourage arm and hand use. We developeda virtual reality (VR) system in order to encourage repetitive task practice. This system combined an assistive glove with a novel VR environment. A set of exercises for this system was developed to encourage specific movements. Six stroke survivors with chronic upper extremity hemiparesis volunteered to participate in a pilot study in which they completed 18 one-hour training sessions with the VR system. Performance with the system was recorded across the 18 training sessions. Clinical evaluations of motor control were conducted at three time points: prior to initiation of training, following the end of training, and 1 month later. Subjects displayed significant improvement on performance of the virtual tasks over the course of the training, although for the clinical outcome measures only lateral pinch showed significant improvement. Future expansion to multi-user virtual environments may extend the benefits of this system for stroke survivors with hemiparesis by furthering engagement in the rehabilitation exercises.

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Abbreviations

3D:

Three-dimensional

ARAT:

Action research arm test

BBT:

Box and blocks test

CMSA_A:

Chedoke-McMaster stroke assessment, stage of arm

CMSA_H:

Chedoke-McMaster stroke assessment, stage of hand

FMUE:

Fugl-Meyer assessment for the upper extremity

FMWH:

Fugl-Meyer assessment for the wrist and hand

GUI:

Graphical user interface

HMD:

Head mounted display

VR:

Virtual reality

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Acknowledgments

This project has been supported as part of the Rehabilitation Engineering Research Center, “Machines Assisting Recovery from Stroke,” funded by the National Institute on Disability and Rehabilitation Research (H133E070013), and by the Coleman Foundation. Thanks to Jose Mauricio Ochoa for research engineering support, to Emil Davchev, Santiago Acosta, Borislav Bahariev for system administration support, Jake O’Toole for collecting subject data, and to D. Minori Keefe for software assistance. Thanks to Katherine Richardson and Heidi Fischer for help with training subjects. Special thanks to all volunteers who participated in the study.

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Authors and Affiliations

  1. School of Design, University of Illinois at Chicago, 929 W. Harrison St., Chicago, IL, 60607, USA

    Daria Tsoupikova & Yu Li

  2. Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL, 60611, USA

    Nikolay S. Stoykov, Molly Corrigan, Kelly Thielbar, Kristen Triandafilou & Derek Kamper

  3. Art Therapy, School of the Art Institute of Chicago, Chicago, IL, 60603, USA

    Randy Vick

  4. Department of Biological Sciences, University of Wisconsin Parkside, Kenosha, WI, 53141, USA

    Fabian Preuss

  5. Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, 60616, USA

    Derek Kamper

Authors
  1. Daria Tsoupikova
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  2. Nikolay S. Stoykov
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  3. Molly Corrigan
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  4. Kelly Thielbar
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  5. Randy Vick
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  6. Yu Li
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  7. Kristen Triandafilou
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  8. Fabian Preuss
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  9. Derek Kamper
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Corresponding author

Correspondence to Daria Tsoupikova.

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Associate Editor Amit Gefen oversaw the review of this article.

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Tsoupikova, D., Stoykov, N.S., Corrigan, M. et al. Virtual Immersion for Post-Stroke Hand Rehabilitation Therapy. Ann Biomed Eng 43, 467–477 (2015). https://doi.org/10.1007/s10439-014-1218-y

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  • DOI: https://doi.org/10.1007/s10439-014-1218-y

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