Adapted Virtual Reality Exergaming Using Off-the-Shelf Supplies for Poststroke Hemiparetic Arm Rehabilitation: Case Study
Background: Virtual reality (VR) can supplement exercise therapy for poststroke upper-arm hemiparesis, but treatments have been largely limited by specialized or costly equipment, hindering replicability and generalizability. Objective: This study examined the #feasibility of using a commercially available bundle of VR supplies to improve hemiparetic arm function before and after an exergaming program in an individual post stroke. Methods: We conducted a pre-post case study (male, aged 72 years, chronic stroke) of a 20-day VR exergaming program (1-hour session per day) using a head-mounted display (Meta Quest 2), with adaptive software (WalkinVR) to boost and adjust in-game movements. Measures of upper-arm function were performed at preintervention (day 0), midintervention (day 10), and postintervention (day 21) and included the Wolf Motor Function Test (WMFT) and Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH). Data were descriptively analyzed. Results: The participant demonstrated improvement in the mean time to complete tasks of the WMFT by 70.5% (δ=11.73 s; preintervention mean time 16.63, SD 31 s; effect size=0.54) from preintervention to midintervention and 78% (δ=12.96 s; effect size=0.59) from preintervention to postintervention. WMFT mean functional ability score demonstrated an improvement of 18% (δ=0.46 points; preintervention mean score 2.67, SD 0.87 points; effect size=0.59) from preintervention to midintervention and 23% (δ=0.6 points; effect size=0.79) from preintervention to postintervention. Range of motion improved in all joints by an average of 35.64% (SD 20%) from preintervention to postintervention. DASH scores demonstrated minimal improvements across the intervention. Conclusions: VR exergaming with adaptive software could be an easy-to-adopt method for improving the functional ability of the hemiparetic arm among people post stroke. Improvements were potentially meaningful but warrant confirmation in more rigorous study designs.
