Virtual Reality Mirror Therapy (VRMT) to Improve Finger Dexterity in Post-stroke Survivors: A Preliminary Feasibility Study of a Home-based Intervention

Abstract

There are 1.2 million stroke survivors living in the UK, of which approximately 77% have lost some upper limb function. Traditional mirror therapy (MT) uses repetition, motor priming, and action observation to promote motor recovery in stroke patients. Although a range of intense repetitive exposure to therapeutic interventions, such as exercises and mirror therapy, appear key in motor recovery, it can be difficult to keep patients motivated as change can be slow and therapy appears monotonous. Virtual reality (VR) systems offer the ability of tracking hand function, which could benefit MT as it may provide realistic feedback, in a game like environment to increase motivation. In addition, VR may increase the variety of therapeutic exercises needed for patients as it is not restricted by the physical barrier of the mirror box. This study aimed to develop and evaluate the feasibility and effectiveness of a Virtual Reality Mirror Therapy (VRMT) system, intended to improve finger dexterity in post-stroke patients. Ten post stroke participants with upper limb hemiparesis were recruited for this study, which was run virtually at the participants' home. Participants were randomly allocated into three groups: Group 1 used the VRMT intervention; Group 2 used the Ninehole peg (9HPT) test and Group 3 received no intervention (Control group). The results show that Groups 1 and 2 increased their 9HPT scores more than Group 3. Feedback from participants highlighted functional issues with the VR controller, which may have impacted on usability and motivation. The results of this study indicate that VRMT has the potential to improve finger function, can be used by post-stroke individuals and could increase engagement with therapeutic exercises post-conventional treatment.