Post-Stroke Rehabilitation of Distal Upper Limb with New Perspective Technologies: Virtual Reality and Repetitive Transcranial Magnetic Stimulation—A Mini Review

Abstract

Upper extremity motor impairment is the most common sequelae in patients with stroke. Moreover, its continual nature limits the optimal functioning of patients in the activities of daily living. Because of the intrinsic limitations in the conventional form of rehabilitation, the rehabilitation applications have been expanded to technology-driven solutions, such as Virtual Reality and Repetitive Transcranial Magnetic Stimulation (rTMS). The motor relearning processes are influenced by variables, such as task specificity, motivation, and feedback provision, and a VR environment in the form of interactive games could provide novel and motivating customized training solutions for better post-stroke upper limb motor improvement. rTMS being a precise non-invasive brain stimulation method with good control of stimulation parameters, has the potential to facilitate neuroplasticity and hence a good recovery. Although several studies have discussed these forms of approaches and their underlying mechanisms, only a few of them have specifically summarized the synergistic applications of these paradigms. To bridge the gaps, this mini review presents recent research and focuses precisely on the applications of VR and rTMS in distal upper limb rehabilitation. It is anticipated that this article will provide a better representation of the role of VR and rTMS in distal joint upper limb rehabilitation in patients with stroke.

Characterizing upper extremity fine motor function in the presence of white matter hyperintensities: A 7 T MRI cross-sectional study in older adults

“…The gained information could be particularly useful for the diseases with motor symptoms. Several studies reported promising intervention effects for stroke and Alzheimer’s disease through non-invasive neurostimulation protocols ( Ahmed et al, 2023 , Banduni et al, 2023 , Kong et al, 2023 , Williams et al, 2009 ). These brain regions have in the future the potential to be targeted, after their relevance to upper extremity motor symptoms in patients have been assessed further.…”

Bridging the Gap between Basic Research and Clinical Practice: The Growing Role of Translational Neurorehabilitation

“…In fact, NIBS modulates the central nervous system by activating neurons in the brain and cortical excitability in order to further potentiate neuroplastic processes during rehabilitation training [ 49 ]. In particular, the combined use of VR and rTMS could improve the effects of rehabilitation by modulating the activity of damaged brain circuits to provide a beneficial effect [ 50 ]. This is why the integrated use of neuromodulation and the ecological virtual environment can lead to more benefits than the VR intervention alone.…”