Virtual Reality Intervention for Stroke Rehabilitation
In Israel approximately 16,000 people have a stroke each year. Most of these people suffer from weakness or paralysis of half of their body which leads to difficulties performing basic activities of daily life (BADL) such as dressing and walking. Due to the stroke, these individuals need to undergo intensive rehabilitation. After rehabilitation, physical activity has been strongly recommended to maintain their functional level which was achieved during rehabilitation. In addition regular physical activity can prevent secondary condition However, recent findings suggest that people with stroke do not perform enough physical activity with their upper and lower extremities.
The use of Virtual Reality (VR) for rehabilitation has been found to have potential for encouraging active purposeful movement. Many researchers have assessed the feasibility & usability of different VR systems and environments for individuals with stroke. Costly VR systems in addition to off-the-shelf video game consoles (e.g. Sony PlayStation EyeToy, Nintendo Wii) have been found to have great potential to encourage active purposeful movement. However, to date, only a limited number of studies have investigated the effectiveness of VR therapy post-stroke.
Since physical activity is important after stroke and the fact that individuals with stroke are not participating sufficiently in physical activity, I suggest to carry out this study.
The overall aim of this study is to assess the effectiveness of using novel technology of VR therapy to promote the participation in daily physical activity of individuals with stroke. A 'Community based' VR program will be compared to a traditional therapy program in promoting daily physical activity of the lower and upper extremities.
It is hypothesized that the VR intervention will be more efficient than the traditional therapy in promoting physical activity (walking and use of the weak upper extremity).
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
|Official Title:||Virtual Reality Intervention for Stroke Rehabilitation|
- Physical activity of the lower and upper extremities [ Time Frame: 6 months ] [ Designated as safety issue: No ]Physical activity of the lower and upper extremities will be measured using accelerometers to quantify the amount of hand usage, the number of steps taken per day and energy expenditure.
- The Fugl-Meyer Motor Assessment (FMA) (upper extremity subtest) [ Time Frame: 6 months ] [ Designated as safety issue: No ]To assess the motor impairment of the upper extremity after stroke. Each movement is graded on a 3-point scale and the total score for the upper extremity ranges from 0-60 points.
- The Action Research Arm Test (ARAT) [ Time Frame: 6 months ] [ Designated as safety issue: No ]To assess the functional ability of the upper extremity by grasping and moving objects of different size and weight. It has four subtests; grasp, grip, pinch and gross movement. The total score is out of 57 points.
- The Box and Blocks test [ Time Frame: 6 months ] [ Designated as safety issue: No ]To assess manual dexterity. The subject is required to transfer as many blocks from one side of a box, over a divider, to the other side, in one minute. The number of blocks transported from one side of a box to the other in one minute is counted.
- The 10-meter walk test (10MWT) [ Time Frame: 6 months ] [ Designated as safety issue: No ]To assess gait speed. Subjects will be asked to walk along a 14-m walkway at their comfortable walking speed using their usual walking aids. Gait speed will be calculated from the time taken to traverse the middle 10 meters, as measured by a stop-watch. The average speed will be calculated from 3 trials.
- Timed get up & Go Test [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]To measure mobility. It includes standing from a seating position, walking, turning, stopping, and sitting down which are all important tasks needed for a person to be independently mobile. For the test, the person is asked to stand up from a standard chair and walk a distance of 3 meters, turn around and walk back to the chair and sit down again. The time to complete this is recorded.
- The Executive Functions Route Finding Test (EFRT) [ Time Frame: 6 months ] [ Designated as safety issue: No ]To assess Executive Functioning. It involves the finding of an unfamiliar destination (office/room), located on a different floor from their current location. The examiner follows the participant and provides specific cues when needed.
- Walking while Talking (WWT) [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]To assess the ability to divide and switch attention between 2 tasks during a 6 meter walk, turn and return. Subjects will walk while reciting consecutive letters of the alphabet aloud and while reciting alternate letters of the alphabet (i.e., a, c, e,…). The walking time and the number of mistakes will be recorded.
|Study Start Date:||September 2011|
|Study Completion Date:||August 2013|
|Primary Completion Date:||August 2013 (Final data collection date for primary outcome measure)|
Experimental: Virtual Reality Therapy
The VR-therapy will include the playing of various virtual reality or video-games which encourages the use of the extremities while sitting and standing.
Other: Virtual Reality
The VR-therapy will include the playing of various virtual reality or video-games which encourages the use of the extremities while sitting and standing
Other Name: 'Community based' VR program
Active Comparator: Traditional Therapy
The traditional therapy will include exercises for balance and walking and for the upper extremity using traditional therapeutic tools such as balls, weights, chairs, bands, steps, etc.
Other: Traditional Therapy
The traditional therapy will include exercise for balance and walking and for the upper extremity using traditional therapeutic tools such as balls, weights, chairs, bands, steps, etc.
Other Name: 'Community based' Traditional therapy program
Show Detailed Description
Please refer to this study by its ClinicalTrials.gov identifier: NCT01304017
|Study Director:||Debbie Rand, PhD||Tel Aviv University|
|Principal Investigator:||Harold Weingarden, MD||Sheba Medical Center|