Rehabilitation of patients with ischemic stroke using virtual reality: a prospective randomized study

Introduction. The current problem lies in developing and evaluating the effectiveness of new rehabilitation methods for patients with ischaemic stroke during the acute phase. Aim. To evaluate the result of a prospective (6 month) follow-up of patients with ischemic stroke after rehabilitation using virtual reality on the dynamics of mobility and motor functions of the lower extremities. Materials and methods. On the basis of Regional Hospital No. 23 (Yalutorovsk), in the primary vascular department (neurological profile), a single-center prospective randomized trial was conducted to evaluate the effectiveness of integrated rehabilitation methods using virtual reality in patients with ischemic stroke. By the method of blind randomization, after receiving written consent to participate in the study, the patients were divided into 3 groups. All three groups underwent an identical rehabilitation course according to clinical recommendations after the end of the acute period of stroke. The main group (n = 30) patients received immersive virtual (VR) and augmented reality (AR) in addition to the basic rehabilitation course. The comparison group (n = 30) — patients received basic rehabilitation, etc. The control group (n = 30) — patients received a basic course of rehabilitation without AR and VR. The effectiveness was assessed using identical clinical and functional scales after the rehabilitation course and after 6 months. Results and discussion. Examination of patients after 10 days showed an increase in strength in the lower extremities and improved coordination in support. In the main group, after 10 days, the load distribution index on the affected side increased from 39 13; 94 % to 46 15; 63 % on stabilometry, compared with 31.5 6; 88 % to 41 9; 71 % in the control group (p 0.05). There was a decrease in the severity of disorders in the functioning of patients in all three groups. After 6 months, it was revealed that in the main group, 50 % of the patients had moderate neurological disorders that had developed into milder grades. The results indicated a better recovery in the main group with VR and AR. Conclusion. As a result of the study, positive effects were noted in the use of rehabilitation of patients with ischemic stroke with the inclusion of immersive and augmented virtual reality. The technique can be used for rehabilitation in the acute period of ischemic stroke in the preparation of rehabilitation programs and is subject to further study.