Video augmented mirror therapy for upper extremity rehabilitation after stroke: a randomized controlled trial

360° immersive virtual reality-based mirror therapy for upper extremity function and satisfaction among stroke patients: a randomized controlled trial

BACKGROUND

Stroke is a leading cause of long-term disability worldwide; therefore, an effective rehabilitation strategy is fundamental. Mirror therapy (MT) has been a popular approach for upper extremity rehabilitation, but it presents some limitations. Recent advancements in virtual reality (VR) technology have introduced immersive VR-based MT, potentially overcoming these limitations and enhancing rehabilitation outcomes.

AIM

This study aimed to evaluate the effectiveness of a novel 360° immersive virtual reality-based MT (360MT) in upper extremity rehabilitation for stroke patients, comparing it to traditional MT (TMT) and conventional physical therapy control group (CG).

DESIGN

A prospective, active control, assessor blinded, parallel groups, randomized controlled trial.

POPULATION

Forty-five participants with chronic stroke within six months of onset.

METHODS

The participants were randomly allocated to 360MT, TMT, or CG groups. Outcome measures included Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Box and Block Test (BBT), and Manual Function Test (MFT). Additionally, patient experience and satisfaction in the groups of 360MT and TMT were assessed through questionnaires and interviews.

RESULTS

Results revealed that the 360MT group showed significantly greater improvements in FMA-UE, MFT and BBT compared to TMT (P<0.05) and CG (P<0.001) groups. Patient experience and satisfaction were more favorable in the 360MT group, with participants reporting higher engagement and motivation.

CONCLUSIONS

360MT appears to be a promising approach for upper extremity rehabilitation in stroke patients, providing better outcomes and higher patient satisfaction. However, further research is needed to confirm these findings and strengthen the evidence base for 360MT in stroke rehabilitation.

CLINICAL REHABILITATION IMPACT

360MT demonstrated notably enhanced upper extremity rehabilitation outcomes as well as better patient satisfaction among chronic stroke patients within six months of onset compared to traditional MT and conventional physical therapy. This novel approach not only fostered functional improvements but also elevated levels of engagement and motivation among participants, suggesting a promising future application in stroke rehabilitation framework.

Feasibility, safety, and efficacy of task-oriented mirrored robotic training on upper-limb functions and activities of daily living in subacute poststroke patients: a pilot study

BACKGROUND

Robotic training with high repetitions facilitates upper-limb movements but provides fewer benefits for activities of daily living. Integrating activities of daily living training tasks and mirror therapy into a robot may enhance the functional gains of robotic training.

AIM

The aim of this study was to investigate the feasibility, safety, and efficacy of the task-oriented mirrored upper-limb robotic training on the upper-limb functions and activities of daily living of subacute poststroke patients.

DESIGN

This study is a single-blinded, active-controlled pilot study.

SETTING

The study was carried out at rehabilitation outpatient clinic and ward.

POPULATION

A total of 32 subacute poststroke patients were enrolled in the study.

METHODS

The enrolled patients were allocated into two groups in a ratio of 1:1. The experimental group received 4 weeks of task-oriented mirrored upper-limb robotic training, consisting of five sessions of 30-minute duration, along with 30 minutes of conventional training. The control group only received 60 minutes of conventional training. The outcome measures were the Fugl-Meyer Assessment Scale for Upper Extremity, Modified Barthel Index, Stroke Self-Efficacy Scale, System Usability Scale, and Quebec User Evaluation with Assistive Technology.

RESULTS

All patients completed the full training sessions without significant adverse events related to robotic training. The task-oriented mirrored upper-limb robotic training led to increased Fugl-Meyer Assessment Scale for Upper Extremity (difference: 10.38 points, P<0.001) and Modified Barthel Index (difference: 18.38 points, P<0.001) scores, both of which exceeded the minimal clinically important difference. Intergroup analysis showed significantly higher improvements in the Fugl-Meyer Assessment Scale for Upper Extremity total scores, shoulder, wrist, and hand scores; and Modified Barthel Index scores in the experimental group than in conventional training (all P<0.05). Both groups showed significant improvements in Stroke Self-Efficacy Scale scores after the intervention (both P<0.001), but without a statistically significant intergroup difference (P>0.05). Participants in the experimental group scored an average usability perception score of 74.74 (good) and an average satisfaction score of four or more out of five.

CONCLUSIONS

In general, task-oriented mirrored upper-limb robotic training appears feasible and safe for subacute poststroke rehabilitation, facilitating the recovery of upper-limb functions and activities of daily living.

CLINICAL REHABILITATION IMPACT

Task-oriented mirrored upper-limb robotic training shows promise for future clinical rehabilitation and clinical trials involving subacute poststroke patients.

Agreement between Azure Kinect and Marker-Based Motion Analysis during Functional Movements: A Feasibility Study

(1) Background: The present study investigated the agreement between the Azure Kinect and marker-based motion analysis during functional movements. (2) Methods: Twelve healthy adults participated in this study and performed a total of six different tasks including front view squat, side view squat, forward reach, lateral reach, front view lunge, and side view lunge. Movement data were collected using an Azure Kinect and 12 infrared cameras while the participants performed the movements. The comparability between marker-based motion analysis and Azure Kinect was visualized using Bland-Altman plots and scatter plots. (3) Results: During the front view of squat motions, hip and knee joint angles showed moderate and high level of concurrent validity, respectively. The side view of squat motions showed moderate to good in the visible hip joint angles, whereas hidden hip joint angle showed poor concurrent validity. The knee joint angles showed variation between excellent and moderate concurrent validity depending on the visibility. The forward reach motions showed moderate concurrent validity for both shoulder angles, whereas the lateral reach motions showed excellent concurrent validity. During the front view of lunge motions, both the hip and knee joint angles showed moderate concurrent validity. The side view of lunge motions showed variations in concurrent validity, while the right hip joint angle showed good concurrent validity; the left hip joint showed poor concurrent validity. (4) Conclusions: The overall agreement between the Azure Kinect and marker-based motion analysis system was moderate to good when the body segments were visible to the Azure Kinect, yet the accuracy of tracking hidden body parts is still a concern.