A New Reality for Stroke Patients?

Traditional post-stroke rehabilitation programs are designed to improve motor and sensory abilities. With the help of specially trained nurses, physical, and occupational therapists survivors relearn the skills needed for activities such as personal grooming, preparing meals, and housecleaning.  This may all be about to change.

A new study has shown that virtual reality games may be the key to recovery. The results show that the patients were more likely to improve their arm strength if they played virtual reality games than if they received standard physical therapy.  The study will be published in the May issue of Stroke.

Stroke survivors suffer mobility problems when parts of the brain controlling leg or arm muscles are impaired. Rehabilitation exercises can help the brain create new connections between nerve cells. Yet, according to study researcher Dr. Gustavo Saposnik, Director of the Stroke Outcomes Research Unit at St. Michael’s Hospital at the University of Toronto, standard therapies provide only modest benefits in terms of improving mobility.

Virtual reality games have been adapted to aid in stroke rehabilitation. In these games, patients interact with a virtual world. They can be immersed in this world by placing a display screen over their eyes, or they can interact with a computer or TV screen, just as they would with a standard video game. The virtual reality games vary in the tasks they ask subjects to perform. Some games require patients to manipulate virtual objects. Other games, including those played on the Nintendo Wii, may require patients to flex their arms and wrists.

Saposnik and his colleagues analyzed 12 studies that tested the effects of virtual reality and electronic games on stroke recovery.

Five of the studies were trials in which patients were randomly assigned to receive standard therapy or play virtual reality games. Taken together, these studies showed patients who played virtual reality games were about 5 times more likely to improve their upper body strength than those who received the standard therapy.

The other seven studies looked at patient improvement before and after playing the games. These studies found on average, a 14.7% improvement in patients’ grip strength and a 20% improvement in their ability to perform standard tasks.

Virtual reality games activate different parts of the brain than standard therapies, which may explain the greater improvement seen in patients who played the games.  The games also activate mirror neurons which are a special type of nerve cell that fire when a person observes someone else performing a particular movement. “Engaging the mirror neuron system probably facilitates the formation of new brain connections and aids in recovery,” Saposnik said.  In addition, virtual reality games can provide auditory and sensory feedback that is important for rehabilitation.

Larger trials are now planned to determine the true benefit of the games.

Have virtual reality games helped you or anyone you know recover from illness?  SRxA’s Word on Health would love to hear from you.

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