Impact of virtual reality-based rehabilitation on functional outcomes in patients with acute stroke: a retrospective case-matched study.
BACKGROUND AND OBJECTIVES
To date, the efficacy of the virtual reality (VR) application for acute stroke compared with conventional therapy (CT) remains unclear. This retrospective study aims to assess the impact of adjuvant VR technology on multidimensional therapy for patients with acute-stage stroke.


METHODS
100 acute ischemic stroke patients with onset within 7 days who underwent combined adjuvant VR-based rehabilitation program and CT (intervention group-VR + CT) were compared to an equal number of cross-matched patients who received CT alone. While the intervention group received 40-min CT plus 20-min VR program (seven times for 1 week), the comparison group received time-matched CT alone. The National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), medical cost-effectiveness, and shortening of hospital stay were used as outcome measures.


RESULTS
Posttreatment, the VR + CT group revealed significantly improved NIHSS and mRS (P < 0.001), whereas only the mRS improvement was remarkable in the CT group. In between-group comparisons, the intervention group had better improvements of symptom severity (NIHSS percentage improvement from the baseline; 20.18% vs. 4.59%, P < 0.005), functional outcomes (mRS improvement from the baseline; - 0.58 vs. - 0.23, P < 0.001), and reduced medical cost (Taiwan dollar; 49474 vs. 66306, P < 0.005). Furthermore, the VR + CT group reached markedly higher proportion of functional independence in activities of daily living (mRS, 0-2) at discharge compared with the CT group (68% vs. 60%, P < 0.001).


CONCLUSIONS
This study suggests that the combination of VR-based rehabilitation and traditional therapy could be more effective for neurorehabilitation than CT alone in the early improvement of symptom severity, functional outcomes, and lower medical expenditure in acute stroke patients.
['Ho|Tsung-Han|TH|', 'Yang|Fu-Chi|FC|', 'Lin|Ruei-Ching|RC|', 'Chien|Wu-Chien|WC|', 'Chung|Chi-Hsiang|CH|', 'Chiang|Shang-Lin|SL|', 'Chou|Chung-Hsing|CH|', 'Tsai|Chia-Kuang|CK|', 'Tsai|Chia-Lin|CL|', 'Lin|Yu-Kai|YK|', 'Lee|Jiunn-Tay|JT|']
D000368:Aged D000369:Aged, 80 and over D002545:Brain Ischemia D016022:Case-Control Studies D003131:Combined Modality Therapy D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D017063:Outcome Assessment, Health Care D012189:Retrospective Studies D020521:Stroke D000071939:Stroke Rehabilitation D063367:Virtual Reality Exposure Therapy
Acute stroke Virtual reality National Institutes of Health Stroke Scale Modified Rankin Scale Activities of daily living Neurorehabilitation Lower medical expenditure