The National Rehabilitation Center in Korea conducted a study to examine the impact of virtual reality-based exercises combined with standard occupational therapy on distal upper extremity function and the health-related quality of life for stroke survivors.

Virtual reality-based treatments have become one of the fastest growing trends in healthcare, but none of the previous studies had provided detailed, quantitative information about the impact of technology on the effectiveness of the rehabilitation process.

The NRC study was a single-blinded, randomized controlled trial, which included 46 stroke survivors divided into experimental and control groups. All participants received a 4-week individual intervention program (20 sessions for 30 minutes per day), as well as daily standard occupational therapy sessions administered by healthcare professionals who were not involved in the experiment. In addition, the patients in the experimental group played virtual reality games generated by the Rapael Smart Glove™.

The RAPAEL Smart Glove™,designed by Neofect, a technology startup with offices in Seoul, Korea and San-Francisco, CA,  is a biofeedback system which includes a glove-shaped sensor device and a software app. The wearable device tracks the 3D motions and posture of the wearer’s distal limb, recognizes functional forearm and wrist movements, and measures the range of finger movement. Data is transmitted via Bluetooth, and the software creates training games by manipulating virtual hands or objects. Therapists can design specific intervention schedules by combining games.

In each game, the wearer must successfully perform a task that is related to the specific movement in order to obtain high scores. The games simulate actions conducted in daily life, such as, writing, page turning, picking up large and small objects, simulated feeding, and stacking checkers. In addition, the system’s  artificial intelligence adjusts the difficulty level according to the participant’s performance, creating a sense of achievement, which is enhanced by audio or visual feedback.

The intervention in the control group comprised of the same movements as those in the experimental group. Therefore, all factors (except the use of the Smart Glove system) were consistent.

Researchers used several standard tests to evaluate the outcomes: Fugl–Meyer assessment scores, the Jebsen–Taylor hand function test, the Purdue pegboard test, and Stroke Impact Scale 3.0 scores. Scores were measured before the program began, in the middle of the intervention, immediately after the  end of the treatment period, and 1 month after the intervention.

There were no differences in scores between the two groups as the study began. At the end of the 4-week period, however, those who used the Smart Glove showed significant progress, while no sizable changes were noted in the control group. The improvements in the experimental group were maintained throughout the following month.

Based on the findings, the researchers believe that virtual reality-based exercises combined with standard occupational therapy may be more effective than amount-matched conventional rehabilitation for improving distal upper extremity function and health-related quality of life.

Restoring upper extremity function is a major goal for stroke survivors, as it is critical for performing daily activities. However, it is often the last body part to recover. Technological innovations in the healthcare industry give the patients new hope of regaining their mobility and improving their quality of life.

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