Application of virtual reality technologies in the rehabilitation of patients with left and right hemisphere lesions in the acute period of ischemic stroke

Abstract

Background: A standard component of early rehabilitation treatment programmes for patients with acute focal brain damage is currently neurocognitive rehabilitation with the integration of innovative virtual reality (VR) technologies. Aims: Based on statistical methodology to evaluate efficiency of the neurocognitive rehabilitation with application virtual reality technologies in patients with left and right hemisphere lesions in the acute period of ischemic stroke. Materials and methods: 160 patients with approved diagnosis “Ischemic stroke” with cognitive impairments were examined. In dependence of the stroke localization patients were split into two groups: the 1st – 80 patients with left hemisphere lesions; the 2nd group – 80 patients with left hemisphere lesions. Since the third day of hospitalization, in addition to a basic therapy, rehabilitation was carried out using a hardware-software multimedia complex based on virtual reality for remote-controlled rehabilitation “Devirta-Delphi”. Rehabilitation efficiency (RE) was assessed by testing objectively measured quantitative measures of accuracy and coordination of movement performance before and after treatment. The assessment of cognitive and psychoemotional measures was performed by using tests on the second day of hospitalization and in the end of the VR-therapy. Mathematical statistic was calculated using Python programing language and its libraries Pandas and SciPy. Results: The results of the research demonstrate higher values of RE in patients with the right-sided stroke. Irrespective of lesion lateralization, significant improvement was noted with respect to mnestic, executive function and ideomotor praxis, regression of anxiety, depression and general aggression. The 1st group of patients also showed an improvement in speech function and a decrease in general asthenia, while the 2nd group of patients showed an increase in attention and emotion recognition ability. As factors negatively affecting RE were identified: in the 1st group - apathy, anxiety, pre-stroke cognitive decline, semantic aphasia, and decreased attention; in the 2nd group - semantic and visual-spatial impairments, pre-stroke decline, and presence of recurrent stroke. Conclusion: The application of immersive environment in the early rehabilitation of patients with cognitive impairment improves the performance of verbal and visual tests reflecting mnestic, regulatory and neurodynamic executive functions at different lateralization of the lesion.