Is motor learning of stroke patients in non-immersive virtual environment influenced by laterality of injury? A preliminary study

Abstract

Background: Stroke is the leading cause of long-term disability in adults, causing residual sensorimotor deficits in many survivors. Patients may have different impairments according to laterality of injury, as well as different responses to some therapies.

Objective: This preliminary study sought to investigate motor learning in rehabilitation of stroke patients with non-immersive virtual environment by process (electroencephalography) and product (performance) measures in stroke patients with left and right cerebral hemispheres damage.

Methods: The study included 10 chronic stroke patients; 5 with left brain injury (LI), mean age 48.8 years (±4.76), and 5 with right brain injury (RI), mean age 52 years (±10.93). Patients were evaluated for electroencephalographic activity (alpha and beta frequencies) and performance (absolute error) in a darts game on XBOX Kinect (Microsoft®). Then they underwent a virtual darts game training task, 12 sessions for 4 weeks (acquisition stage). After training, they were revaluated (long-term retention).

Results: RI group increased alpha power and decreased beta in ipsilesional areas, increased activation on left hemisphere and decreased the absolute error of performance; LI group increased right hemisphere activation and did not decrease the absolute error.

Conclusions: Patients with right brain injury reduce neural effort and errors after virtual darts training, which did not happen to patients with left brain injury. Therefore, the laterality of lesion should be considered in studies that use virtual reality for stroke rehabilitation.

Keywords: Cerebrovascular disorders; Electroencephalography; Paresis; Psychomotor performance.