Virtual reality-guided therapy on a stroke unit: a feasibility study

Abstract Background VR (Virtual Reality) has emerged as a recent treatment approach in neurorehabilitation. The feasibility of VR-guided therapy in the acute phase after stroke has not been assessed. Methods This was a cohort study of consecutive patients with suspected stroke who were admitted to t...

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Main Authors: Jordi Kühne Escolà, Rumeysa Demirdas, Martin Schulze, Woon Hyung Chae, Lennart Steffen Milles, Doreen Pommeranz, Marvin Darkwah Oppong, Christoph Kleinschnitz, Martin Köhrmann, Benedikt Frank
Format: Article
Language:English
Published: BMC 2024-12-01
Series:Neurological Research and Practice
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Online Access:https://doi.org/10.1186/s42466-024-00357-w
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author Jordi Kühne Escolà
Rumeysa Demirdas
Martin Schulze
Woon Hyung Chae
Lennart Steffen Milles
Doreen Pommeranz
Marvin Darkwah Oppong
Christoph Kleinschnitz
Martin Köhrmann
Benedikt Frank
author_facet Jordi Kühne Escolà
Rumeysa Demirdas
Martin Schulze
Woon Hyung Chae
Lennart Steffen Milles
Doreen Pommeranz
Marvin Darkwah Oppong
Christoph Kleinschnitz
Martin Köhrmann
Benedikt Frank
author_sort Jordi Kühne Escolà
collection DOAJ
description Abstract Background VR (Virtual Reality) has emerged as a recent treatment approach in neurorehabilitation. The feasibility of VR-guided therapy in the acute phase after stroke has not been assessed. Methods This was a cohort study of consecutive patients with suspected stroke who were admitted to the Essen University Hospital Stroke Unit between March 2022 and May 2022. All patients who had an indication for physical or occupational therapy due to upper extremity sensorimotor, cognitive or perceptual deficits were included and considered for VR-guided treatment. We excluded patients with predominant deficits in lower extremity function, since these could not be targeted with our VR system. A multidimensional approach was used to assess the feasibility of VR-guided therapy, which included characterization of eligible patients, resource utilization as well as treatment acceptance. For this purpose, we analyzed baseline and clinical characteristics, causes for withholding the treatment as well as qualitative and quantitative treatment metrics in patients who received VR-guided therapy. Results Out of 326 patients admitted with suspected stroke, n = 172 were included in our final analysis. Of these, n = 37 (21.5%) received VR-guided therapy. The most common cause for withholding treatment were neuropsychological limitations (22.9%), followed by physical impairment, comorbidity and level of consciousness alterations (all 17.8%). Patients who received VR-guided therapy tended to have better functional status and less severe neurological deficits. VR-guided sessions had a median duration of 20 min (IQR 17–29) with additional 13 min (IQR 9–17) of preparation time. In the majority of patients who received VR-guided therapy, motivation was rated equal or higher as compared with conventional treatment (76%) and therapists considered VR-guided therapy well feasible (65%). Conclusions Despite important treatment barriers, VR may provide additional opportunities to enhance functional recovery in the acute phase after stroke for selected patients. Our findings could aid in planning further randomized controlled trials which are required to refine approaches and assess the effectiveness of VR-guided therapy in the acute setting.
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spelling doaj-art-d78e575ca81d4cf0a62a500fed0025242025-08-20T02:20:41ZengBMCNeurological Research and Practice2524-34892024-12-01611810.1186/s42466-024-00357-wVirtual reality-guided therapy on a stroke unit: a feasibility studyJordi Kühne Escolà0Rumeysa Demirdas1Martin Schulze2Woon Hyung Chae3Lennart Steffen Milles4Doreen Pommeranz5Marvin Darkwah Oppong6Christoph Kleinschnitz7Martin Köhrmann8Benedikt Frank9Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital EssenDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital EssenDepartment of Physical Therapy, University Hospital EssenDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital EssenDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital EssenDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital EssenDepartment of Neurosurgery and Spine Surgery and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital EssenDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital EssenDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital EssenDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital EssenAbstract Background VR (Virtual Reality) has emerged as a recent treatment approach in neurorehabilitation. The feasibility of VR-guided therapy in the acute phase after stroke has not been assessed. Methods This was a cohort study of consecutive patients with suspected stroke who were admitted to the Essen University Hospital Stroke Unit between March 2022 and May 2022. All patients who had an indication for physical or occupational therapy due to upper extremity sensorimotor, cognitive or perceptual deficits were included and considered for VR-guided treatment. We excluded patients with predominant deficits in lower extremity function, since these could not be targeted with our VR system. A multidimensional approach was used to assess the feasibility of VR-guided therapy, which included characterization of eligible patients, resource utilization as well as treatment acceptance. For this purpose, we analyzed baseline and clinical characteristics, causes for withholding the treatment as well as qualitative and quantitative treatment metrics in patients who received VR-guided therapy. Results Out of 326 patients admitted with suspected stroke, n = 172 were included in our final analysis. Of these, n = 37 (21.5%) received VR-guided therapy. The most common cause for withholding treatment were neuropsychological limitations (22.9%), followed by physical impairment, comorbidity and level of consciousness alterations (all 17.8%). Patients who received VR-guided therapy tended to have better functional status and less severe neurological deficits. VR-guided sessions had a median duration of 20 min (IQR 17–29) with additional 13 min (IQR 9–17) of preparation time. In the majority of patients who received VR-guided therapy, motivation was rated equal or higher as compared with conventional treatment (76%) and therapists considered VR-guided therapy well feasible (65%). Conclusions Despite important treatment barriers, VR may provide additional opportunities to enhance functional recovery in the acute phase after stroke for selected patients. Our findings could aid in planning further randomized controlled trials which are required to refine approaches and assess the effectiveness of VR-guided therapy in the acute setting.https://doi.org/10.1186/s42466-024-00357-wVirtual realityStrokeFunctional recoveryStroke unitPhysical therapyRehabilitation
spellingShingle Jordi Kühne Escolà
Rumeysa Demirdas
Martin Schulze
Woon Hyung Chae
Lennart Steffen Milles
Doreen Pommeranz
Marvin Darkwah Oppong
Christoph Kleinschnitz
Martin Köhrmann
Benedikt Frank
Virtual reality-guided therapy on a stroke unit: a feasibility study
Neurological Research and Practice
Virtual reality
Stroke
Functional recovery
Stroke unit
Physical therapy
Rehabilitation
title Virtual reality-guided therapy on a stroke unit: a feasibility study
title_full Virtual reality-guided therapy on a stroke unit: a feasibility study
title_fullStr Virtual reality-guided therapy on a stroke unit: a feasibility study
title_full_unstemmed Virtual reality-guided therapy on a stroke unit: a feasibility study
title_short Virtual reality-guided therapy on a stroke unit: a feasibility study
title_sort virtual reality guided therapy on a stroke unit a feasibility study
topic Virtual reality
Stroke
Functional recovery
Stroke unit
Physical therapy
Rehabilitation
url https://doi.org/10.1186/s42466-024-00357-w
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