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Virtual Reality Rehabilitation With Functional Electrical Stimulation Improves Upper Extremity Function in Patients With Chronic Stroke: A Pilot Randomized Controlled Study.
Arch Phys Med Rehabil. 2018 08; 99(8):1447-1453.e1.AP

Abstract

OBJECTIVE

To compare virtual reality (VR) combined with functional electrical stimulation (FES) with cyclic FES for improving upper extremity function and health-related quality of life in patients with chronic stroke.

DESIGN

A pilot, randomized, single-blind, controlled trial.

SETTING

Stroke rehabilitation inpatient unit.

PARTICIPANTS

Participants (N=48) with hemiplegia secondary to a unilateral stroke for >3 months and with a hemiplegic wrist extensor Medical Research Council scale score ranging from 1 to 3.

INTERVENTIONS

FES was applied to the wrist extensors and finger extensors. A VR-based wearable rehabilitation device was used combined with FES and virtual activity-based training for the intervention group. The control group received cyclic FES only. Both groups completed 20 sessions over a 4-week period.

MAIN OUTCOME MEASURES

Primary outcome measures were changes in Fugl-Meyer Assessment-Upper Extremity and Wolf Motor Function Test scores. Secondary outcome measures were changes in Box and Block Test, Jebsen-Taylor Hand Function Test, and Stroke Impact Scale scores. Assessments were performed at baseline (t0) and at 2 weeks (t1), 4 weeks (t4), and 8 weeks (t8). Between-group comparisons were evaluated using a repeated-measures analysis of variance.

RESULTS

Forty-one participants were included in the analysis. Compared with FES alone, VR-FES produced a substantial increase in Fugl-Meyer Assessment-distal score (P=.011) and marginal improvement in Jebsen-Taylor Hand Function Test-gross score (P=.057). VR-FES produced greater, although nonsignificant, improvements in all other outcome measures, except in the Stroke Impact Scale-activities of daily living/instrumental activities of daily living score.

CONCLUSIONS

FES with VR-based rehabilitation may be more effective than cyclic FES in improving distal upper extremity gross motor performance poststroke.

Authors+Show Affiliations

Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Republic of Korea.Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Republic of Korea.Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Republic of Korea.Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Republic of Korea.Department of Law, Hanyang University, Seoul, Republic of Korea.Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Republic of Korea. Electronic address: asfreelyas@gmail.com.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29505744

Citation

Lee, Stephanie Hyeyoung, et al. "Virtual Reality Rehabilitation With Functional Electrical Stimulation Improves Upper Extremity Function in Patients With Chronic Stroke: a Pilot Randomized Controlled Study." Archives of Physical Medicine and Rehabilitation, vol. 99, no. 8, 2018, pp. 1447-1453.e1.
Lee SH, Lee JY, Kim MY, et al. Virtual Reality Rehabilitation With Functional Electrical Stimulation Improves Upper Extremity Function in Patients With Chronic Stroke: A Pilot Randomized Controlled Study. Arch Phys Med Rehabil. 2018;99(8):1447-1453.e1.
Lee, S. H., Lee, J. Y., Kim, M. Y., Jeon, Y. J., Kim, S., & Shin, J. H. (2018). Virtual Reality Rehabilitation With Functional Electrical Stimulation Improves Upper Extremity Function in Patients With Chronic Stroke: A Pilot Randomized Controlled Study. Archives of Physical Medicine and Rehabilitation, 99(8), 1447-e1. https://doi.org/10.1016/j.apmr.2018.01.030
Lee SH, et al. Virtual Reality Rehabilitation With Functional Electrical Stimulation Improves Upper Extremity Function in Patients With Chronic Stroke: a Pilot Randomized Controlled Study. Arch Phys Med Rehabil. 2018;99(8):1447-1453.e1. PubMed PMID: 29505744.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Virtual Reality Rehabilitation With Functional Electrical Stimulation Improves Upper Extremity Function in Patients With Chronic Stroke: A Pilot Randomized Controlled Study. AU - Lee,Stephanie Hyeyoung, AU - Lee,Ji-Yeong, AU - Kim,Mi-Young, AU - Jeon,Yu-Jin, AU - Kim,Suyoung, AU - Shin,Joon-Ho, Y1 - 2018/03/02/ PY - 2017/10/18/received PY - 2018/01/21/revised PY - 2018/01/22/accepted PY - 2018/3/6/pubmed PY - 2019/5/2/medline PY - 2018/3/6/entrez KW - Electric stimulation KW - Rehabilitation KW - Stroke KW - Upper extremity KW - Virtual reality SP - 1447 EP - 1453.e1 JF - Archives of physical medicine and rehabilitation JO - Arch Phys Med Rehabil VL - 99 IS - 8 N2 - OBJECTIVE: To compare virtual reality (VR) combined with functional electrical stimulation (FES) with cyclic FES for improving upper extremity function and health-related quality of life in patients with chronic stroke. DESIGN: A pilot, randomized, single-blind, controlled trial. SETTING: Stroke rehabilitation inpatient unit. PARTICIPANTS: Participants (N=48) with hemiplegia secondary to a unilateral stroke for >3 months and with a hemiplegic wrist extensor Medical Research Council scale score ranging from 1 to 3. INTERVENTIONS: FES was applied to the wrist extensors and finger extensors. A VR-based wearable rehabilitation device was used combined with FES and virtual activity-based training for the intervention group. The control group received cyclic FES only. Both groups completed 20 sessions over a 4-week period. MAIN OUTCOME MEASURES: Primary outcome measures were changes in Fugl-Meyer Assessment-Upper Extremity and Wolf Motor Function Test scores. Secondary outcome measures were changes in Box and Block Test, Jebsen-Taylor Hand Function Test, and Stroke Impact Scale scores. Assessments were performed at baseline (t0) and at 2 weeks (t1), 4 weeks (t4), and 8 weeks (t8). Between-group comparisons were evaluated using a repeated-measures analysis of variance. RESULTS: Forty-one participants were included in the analysis. Compared with FES alone, VR-FES produced a substantial increase in Fugl-Meyer Assessment-distal score (P=.011) and marginal improvement in Jebsen-Taylor Hand Function Test-gross score (P=.057). VR-FES produced greater, although nonsignificant, improvements in all other outcome measures, except in the Stroke Impact Scale-activities of daily living/instrumental activities of daily living score. CONCLUSIONS: FES with VR-based rehabilitation may be more effective than cyclic FES in improving distal upper extremity gross motor performance poststroke. SN - 1532-821X UR - https://www.unboundmedicine.com/medline/citation/29505744/Virtual_Reality_Rehabilitation_With_Functional_Electrical_Stimulation_Improves_Upper_Extremity_Function_in_Patients_With_Chronic_Stroke:_A_Pilot_Randomized_Controlled_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-9993(18)30140-0 DB - PRIME DP - Unbound Medicine ER -