Virtual reality exergaming using off-the-shelf supplies improves post-stroke hemiparetic function: a case study. (Preprint)

BACKGROUND Virtual reality (VR) can supplement exercise therapy for post-stroke upper-arm hemiparesis, but treatments have been largely limited by specialized or costly equipment, hindering replicability and generalizability. OBJECTIVE This study examined the feasibility of a commercially available bundle of VR supplies to improve hemi-paretic arm function before and after an exergaming program among a person post-stroke. METHODS Pre-to-post case study (male, age 72 years) of 20-days of VR exergaming program (1 hour session per day) using a head- mounted display (Meta Quest 2), with adaptive software (WalkinVR) to boost and adjust in-game movements. Measures of upper-arm function were performed at pre (day 0), mid (day 10), and post-intervention (day 21) and included the Wolf Motor Function Test (WMFT), Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Data were descriptively analyzed. RESULTS The participant demonstrated improvement in the mean time to complete tasks of the WMFT by 70.5% (delta=11.73 secs / pre=16.63 secs; effect size=0.54) and 50% (12.96 secs / pre=16.63 secs; effect size=0.59) from pre- to mid- and post-intervention, respectively. WMFT mean functional ability score demonstrated an improvement of 18% (delta=0.46 points / pre=2.67 points; effect size=0.59) and 23% (delta=0.6 points / pre=2.67; effect size=0.79) from pre- to mid- and post-intervention, respectively. Range of motion improved in all joints by an average of 35.64% from pre to post intervention. DASH scores demonstrated minimal improvements across the intervention. CONCLUSIONS VR exergaming with adaptive software may elicit clinically meaningful improvements to the functional ability of the hemi-paretic arm. Improvements were substantial, given that benefits were seen as early as 10 days into the program, which warrants further investigation in confirmatory trials. CLINICALTRIAL N/A.