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Virtual Reality Based Interventions Improve Post-stroke Self-perceived Amount and Quality of Upper Limb Use

Sandeep K. Subramanian, PhD, MSc, BPTh (UT Health Science Center San Antonio, San Antonio, TX, United States); Jessica M. Azzopardi, BA, LMT, RYT; Lisa A. Reitz, BS; Timothy A. Reistetter, PhD, OTR, FAOTA

Meeting: AAPM&R Annual Assembly 2019

Session Information

Date: Friday, November 15, 2019

Session Title: Neurological Rehabilitation Research Report

Session Time: 12:30pm-2:00pm

Location: Research Hub - Kiosk 6

Disclosures: Sandeep K. Subramanian, PhD, MSc, BPTh: Nothing to disclose

Objective: The study objective was to examine the influence of virtual reality based interventions on self-perceived amount and quality of upper limb (UL) use after a stroke.

Design: Systematic review and meta-analyses.

Setting: N/A

Participants: Individuals who had sustained a stroke.

Interventions: Using standard methodology, we conducted a literature search of databases including MEDLINE and Google Scholar using keywords related to stroke and virtual reality. We included studies (1) involving adult humans with a diagnosis of stroke; (2) using virtual reality based interventions for UL motor improvement and (3) assessing self-perceived UL use. Studies (1) examining the influence of virtual reality based interventions on lower limb motor improvements, (2) involving assessment of only cognitive outcomes and (3) single case studies were excluded. The Downs and Black Checklist helped assess quality of the retrieved studies. We compared changes in self-perceived levels of amount and quality of UL use immediately after the intervention and at retention using standardized mean differences and summary effect sizes. We used the RevMan5 software for conducting the meta-analyses.

Main Outcome Measures: Motor Activity Log – Quality of Movement (MAL-QoM) and Amount of USE (MAL-AoU) scores.

Results: We retrieved a total of 11 studies. Quality of the published studies ranked from fair to excellent. Immediately, after completion of the intervention, use of virtual reality interventions resulted in an increase in self-perceived quality (MAL-QoM scores; 11 studies; effect Size: 0.32, 95% CI: 0.07 to 0.56). Similar positive effects were seen in self-perceived amount (MAL-AoU scores: 10 studies, effect size: 0.27, 95% CI: 0.02 to 0.53) as well. However, these changes were not retained for the MAL-QoM (7 studies, effect size 0.26, 95% CI: -0.18 to 0.71) or the MAL-AoU (8 studies, effect size: -0.04, effect size: -0.25 to 0.17) scores.

Conclusions: Virtual reality based interventions are beneficial in improving self-perceived quality and amount of post-stroke UL use.

Level of Evidence: Level I

To cite this abstract in AMA style:

Subramanian SK, Azzopardi JM, Reitz LA, Reistetter TA. Virtual Reality Based Interventions Improve Post-stroke Self-perceived Amount and Quality of Upper Limb Use [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/virtual-reality-based-interventions-improve-post-stroke-self-perceived-amount-and-quality-of-upper-limb-use/. Accessed May 14, 2025.
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