EFFECTS OF VIRTUAL REALITY TRAINING (VRT) WITH MODIFIED CONSTRAINT-INDUCED MOVEMENT THERAPY (m-CIMT) ON HAND FUNCTION IN ACUTE STROKE SUBJECTS. A RANDOMIZED CONTROL TRIAL

Background And Purpose: The use of VR training has increased the potential for motor learning and neuroplasticity during hand rehabilitation. m-CIMT enhances the use and skill of the paretic hand in daily life by improving the motor function. The purpose of this study was to evaluate the effectiveness of Virtual Reality Training (VRT) with Modied constraint-induced movement therapy (m-CIMT) on hand function in acute stroke subjects. Methodology: 30 acute stroke subjects who met inclusive criteria with MMSE 24 or > 24 and Brunnstrom's motor stage of hand recovery ≥ 4 were selected by using the lottery method. Subjects were randomly allotted to Group-A15(experimental) and Group-B 15(control) after getting written consent from the subjects. Group-Areceived VRT along with m-CIMT, while Group-B received only m-CIMT hand function training. The study was conducted for a total of 12 sessions over 4 weeks. Pre-test and post-test evaluation of hand function done by using the Jebsen Taylor Hand Function Test (JTHFT) and Box and Block Test (BBT). Results: Pre-test and post-test values of JTHFT and BBT within the experimental and control groups showed statistically signicant improvement (p< 0.001). But comparatively, mean ± SD difference is greater in the experimental group than in control group. Discussion: This study revealed that integrated VRT with m-CIMT on hand function training in acute stroke subjects showed more improvement than Existing VRT and m-CIMT alone by increasing cortex representation and resulting in brain reorganization. Conclusion: Results of the study concluded that integrated VRT with m-CIMThand function training shows more improvement in the recovery of hand function in acute stroke subjects than in m-CIMT.