Stroke Affected Lower Limbs Rehabilitation Combining Virtual Reality With Tactile Feedback

Alexander V Zakharov; Vladimir A Bulanov; Elena V Khivintseva; Alexander V Kolsanov; Yulia V Bushkova; Galina E Ivanova

doi:10.3389/frobt.2020.00081

Stroke Affected Lower Limbs Rehabilitation Combining Virtual Reality With Tactile Feedback

Front Robot AI. 2020 Jul 9:7:81. doi: 10.3389/frobt.2020.00081. eCollection 2020.

Authors

Alexander V Zakharov¹, Vladimir A Bulanov², Elena V Khivintseva¹, Alexander V Kolsanov³, Yulia V Bushkova⁴, Galina E Ivanova⁴

Affiliations

¹ Department of Neurology and Neurosurgery, Samara State Medical University, Samara, Russia.
² MathBio Laboratory, IT Universe Ltd., Samara, Russia.
³ Institute for Innovative Development, Samara State Medical University, Samara, Russia.
⁴ Research Center of Cerebrovascular Pathology and Stroke, Ministry of Health of the Russian Federation, Moscow, Russia.

Abstract

In our study, we tested a combination of virtual reality (VR) and robotics in the original adjuvant method of post-stroke lower limb walk restoration in acute phase using a simulation with visual and tactile biofeedback based on VR immersion and physical impact to the soles of patients. The duration of adjuvant therapy was 10 daily sessions of 15 min each. The study showed the following significant rehabilitation progress in Control (N = 27) vs. Experimental (N = 35) groups, respectively: 1.56 ± 0.29 (mean ± SD) and 2.51 ± 0.31 points by Rivermead Mobility Index (p = 0.0286); 2.15 ± 0.84 and 6.29 ± 1.20 points by Fugl-Meyer Assessment Lower Extremities scale (p = 0.0127); and 6.19 ± 1.36 and 13.49 ± 2.26 points by Berg Balance scale (p = 0.0163). P-values were obtained by the Mann-Whitney U test. The simple and intuitive mechanism of rehabilitation, including through the use of sensory and semantic components, allows the therapy of a patient with diaschisis and afferent and motor aphasia. Safety of use allows one to apply the proposed method of therapy at the earliest stage of a stroke. We consider the main finding of this study that the application of rehabilitation with implicit interaction with VR environment produced by the robotics action has measurable significant influence on the restoration of the affected motor function of the lower limbs compared with standard rehabilitation therapy.

Keywords: biofeedback; rehabilitation; stroke; tactile feedback; virtual reality.