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Virtual reality rehabilitation for stroke patients

by Eza Surya Mohd Arip, Waidah Ismail, Md Jan Nordin, and Abduljalil Radman, AIP Conference Proceedings; https://doi.org/10.1063/1.5012226



Stroke is one of the main causes of disability in the world. In order for stroke survivors to reduce their disability,
they need to go through a rehabilitation process to regain back their independence and improve their quality of life. To guide patients in their rehabilitation process and improve their receptiveness in performing repetitive exercises, a new rehabilitation training program using Virtual Reality (VR) technology has been introduced. This has attracted many researchers to explore more on VR technology as a new tool for stroke patient’s rehabilitation. This paper presents a review on existing VR systems that have been developed for stroke rehabilitation. First, recent VR systems utilized for rehabilitation after stroke are delineated and categorized. Each of these categories concludes with a discussion on limitations and any issues that arise from it. Finally, a concise summary with significant findings and future possibilities in VR rehabilitation research is presented in table format.


Stroke rehabilitation

Concerning stroke survivors, the goal of their rehabilitation process is to regain independence and improve the
quality of life. This process often involves physical therapy, occupational therapy and speech therapy. Patients need
to learn again the skills they lost when part of the brain was damaged. The severity of stroke complications and their ability to recover vary for each patient. Depending on which part of the body or ability affected, physical activities or exercises that may be administered by a therapist: strengthening of motor skills, mobility training, force-use therapy, and range of motion therapy include [9]:

  • Strengthening motor skills are exercises that help patients improve their muscle strength and coordination.
    This also includes the ability to swallow food.
  • Mobility training involves the activity of learning to use walking aids such as a walker or brace to stabilize
    and support the body weight while learning to walk.
  • Force-use therapy is basically forcing the use of an affected limb to improve its function instead of relying
    on an unaffected limb.
  • Range of motion therapy is exercise or even medication designed to reduce muscle tension and to regain
    range of motion of an affected limb.


Immersive and non-immersive systems

There are many types of VR systems utilized in the field of neurorehabilitation. Immersive VR simulates a virtual environment that makes the user perceive or feel that they are present in the virtual environment itself. This is known as the “presence” concept. This concept is made possible by using VR tools that is either worn or placed in front of the user. Example of such VR tools are head mounted displays, stereoscopic glasses and large screen projections. On the other hand, non-immersive VR creates an environment that is seen through a television screen or computer monitor. This type of VR uses a simpler set-up, either with or without the use of tools. Some examples are a joy stick, mouse or VR gloves including computer systems and video games. 






Main attributes

·         Positive potential in improving motor functions

·        Increases the activity of the patient's cognitive function and central nervous system.

·        Low-cost, easy to use, motivating and effective.

·        Able to provide report on the patient’s progress and improvement

·        Proven to be a feasible and safe rehabilitation tool

·        Need minimal supervision which is suitable for a home-based rehabilitation therapy program.

Future research possibilities

·        To include a larger sample size for a more conclusive result

·        To implement a combination of visual, motor and auditory components in 3D VR studies

·        HMD needs to be upgraded to a lighter unit with higher resolution

·        To do more studies in mobile based VR system

·        To include a larger sample size for a more conclusive result

·        To improve the system further by considering patient’s feeling of virtual objects through the use of a more powerful haptic device.



From the numerous studies on VR implementation in the rehabilitation program for stroke patients, it is found that
most of them use non-immersive VR type, which usually focuses more on improving motor skills that are related to
ADL. Fast growing technology development related to non-immersive VR can be related to more studies on this. For
immersive VR which includes cognitive learning skills, besides motor skills, there is a lack of specific evidence and
discussion in the immersive VR type and its effects on stroke. The complexity of immersive VR compared to nonimmersive can be related to less studies on immersive VR in rehabilitation. However, all the studies above do support the claim that VR has shown positive effects on cognitive function, motor function and rehabilitation in general.







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