Virtual Therapy as an Occupational Therapy tool in patients with Cerebrovascular Event.

Abstract

Introduction

Stroke is one of the leading causes of disability in adults due to the motor and functional sequelae that affect patients’ independence and quality of life. Common impairments include decreased muscle strength, loss of coordination, and upper-limb dysfunction, which directly impact activities of daily living (ADLs). In this context, virtual reality (VR) technologies have emerged as innovative rehabilitation tools because they promote motivation and repetitive practice of functional movements.

In Mexico, the National Institute of Astrophysics, Optics and Electronics (INAOE) developed a virtual reality system called Gesture Therapy (GT), specifically designed for patients who have suffered a stroke. This system integrates exercises related to ADLs with the aim of improving upper-limb motor recovery.

Objective

To evaluate the effect of conventional occupational therapy combined with the Gesture Therapy virtual reality system on upper-limb motor and functional recovery in patients with chronic stroke.

Methodology

A repeated-measures study was conducted in a group of seven patients diagnosed with chronic stroke. The intervention program consisted of 10 rehabilitation sessions, including 30 minutes of conventional occupational therapy and 30 minutes of training using the Gesture Therapy system.

The program was supervised by a rehabilitation physician and an occupational therapist. Evaluations were performed at baseline (S1), midway through treatment (S5), and at the end of the intervention (S10), using the Motor Index and the Fugl-Meyer Assessment for the upper limb (sections A and B). At the end of the study, an intrinsic motivation scale was administered to evaluate participants’ acceptance of and engagement with the treatment. Statistical analysis was performed using the Friedman test for related samples and the Wilcoxon test with Bonferroni correction for post hoc analyses (critical alpha = .016).

Results

Among the participants, 85.7% had ischemic stroke and 57.1% presented involvement of the left upper limb; 43% were male. Five patients completed the intervention program.

The results showed significant improvement in grasping and manipulation abilities of the affected hand, as well as in mobility, strength, and motor coordination. Significant differences were observed between baseline and final evaluations in the Motor Index (Z = -1.9, p = .008), the Fugl-Meyer scale (Z = -2, p = .005), and sections A and B (Z = 1.9, p = .008). In addition, patients reported high levels of motivation and adherence to treatment.

Conclusions

The combination of Gesture Therapy and conventional occupational therapy promotes upper-limb functional recovery in patients with stroke sequelae. Furthermore, it contributes to improving performance in activities of daily living and active participation in the rehabilitation process.