Use of Virtual Rehabilitation to Improve the Symmetry of Body Temperature, Balance, and Functionality of Patients with Stroke Sequelae

Ann Neurosci. 2019 Jan;25(3):166-173. doi: 10.1159/000488581. Epub 2018 Jun 7.

Abstract

Background: Stroke rehabilitation that is based on the patients' needs, experiences, and priorities requires extensive knowledge and skills to capture and integrate the perspectives of the subject.

Purpose: The objective of this study was to evaluate the acute effect of an occupational therapy protocol associated with virtual reality (VR) on the symmetry of body temperature (BTP), balance, and functionality of patients with stroke sequelae.

Methods: Ten patients (69.84 ± 7.55 years) diagnosed with stroke between 2 and 10 years earlier were evaluated during clinical care sessions integrated with VR games. Associated with games, all patients were stimulated to use both upper and lower limbs and distribute body weight symmetrically, and perceptual stimuli of body-half training, alignment, postural control, and balance were given. The variables of thermography (temperature [°C] and body asymmetry) of the upper and lower limbs, balance (Berg scale), and functionality were analyzed before and after the test.

Results: BTP was reduced in the 4 upper and lower limb body regions of interest: the right arm (p = 0.024, Cohen's d = 1.02), previous direct hand (p = 0.034, Cohen's d = 1.22), right back hand (p = 0.003, Cohen's d = 1.85) and Left (p = 0.013, Cohen's d = 0.92), right thigh (p = 0.035, Cohen's d = 1.32), and left thigh (p = 0.047, Cohen's d = 0.92). The mean of the bilateral asymmetry variation of the arm in the anterior position at the pre test was classified according to the level of attention monitoring (which means that the asymmetry rate is above normal), changing its state at the end of the intervention to normal. There was an increase in the functional independence score (p = 0.015, Cohen's d = 0.50) and in the static and dynamic balance function (p = 0.001, Cohen's d = 0.07).

Conclusion: VR associated with occupational therapeutic planning can amplify and potentiate neurological recovery following stroke.

Keywords: Body asymmetry; Occupational therapy; Stroke; Virtual reality.