Virtual Reality Might Help Stroke Patients

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Resent research reported in Stroke: Journal of the American Heart Association shows virtual reality and other video games could lead to significant improvement in the arm strength of patients after a stroke. As a result, video games could prove to be an affordable as well as an enjoyable and effective way to help stroke victims as they're going through treatment.

Studies show that training designed to maximize the brain's ability to repair itself should be challenging, repetitive, task-specific, motivating and novel. These qualities are part of playing video games, especially virtual reality type games, so it makes sense that gaming could actually help stroke victims.

Virtual Reality May Lead to Real-World Improvement for Stroke Patients

Study Highlights:

-  Virtual reality games appear to give a real-life boost to stroke patients’ recovery.

-  A meta-analysis of previous trials found patients who played electronic games had a higher chance of improved motor strength compared to those who received conventional therapy.

DALLAS, April 7, 2011 /PRNewswire-USNewswire/ -- Virtual reality (VR) and other video games led to significant improvement in arm strength following stroke and could provide an affordable, enjoyable and effective way to intensify treatment, according to research reported in Stroke: Journal of the American Heart Association.

Researchers analyzed seven observational and five randomized trials, representing a total of 195 patients, ages 26 to 88, who had suffered mild to moderate strokes. Each study had investigated the effects of electronic games on upper arm strength and function.  

In the observational studies, there was an average 14.7 percent improvement in motor strength after virtual reality sessions. There was a 20 percent average improvement in motor function, or the ability to perform standard tasks. In the randomized clinical trials, patients who played virtual reality games showed a statistically significant 4.89 times higher chance of improvement in motor strength compared to those who got standard therapy.

"Virtual reality gaming is a promising and potentially useful alternative to enhance motor improvement after stroke," said Gustavo Saposnik, M.D., M.Sc., lead author of the study and director of the Stroke Outcomes Research Unit at St. Michael's Hospital at the University of Toronto. "Virtual reality gaming therapy may provide an affordable, enjoyable and effective alternative to intensify treatment and promote motor recovery after stroke."

Between 55 percent and 75 percent of stroke survivors continue to experience motor deficits that reduce their quality of life, yet conventional therapy provides "modest and sometimes delayed effects," said Saposnik, also an assistant professor in the hospital's department of medicine.

Recent research indicates the brain has a remarkable potential for remodelling because after injury it shows neuroplasticity, the ability to create new nerve cell connections. Those studies indicate that training designed to maximize the brain's remodelling potential should be challenging, repetitive, task-specific, motivating and novel. All of those are qualities of video-gaming, especially virtual reality systems in which players interact with a multisensory simulated environment via a wireless controller and receive real-time feedback on their performance.

Saposnik said advantages of virtual reality systems include:

  • real-time feedback providing immediate positive reinforcement;
  • multi-sensorial feedback, including vision, hearing and sensory perception;
  • computer-assisted movement;
  • simple graphics; and
  • potential for modifiable speed that enables participation over a wide range of patients including those with a cognitive impairment.

Although treatment varied by study, most patients played 20 to 30 hours during four to six weeks of therapy on one of several computer-based technology systems: three traditional video game systems (i.e., Glasstron, IREX®, Playstation®  Eye Toy®) and nine virtual reality systems (e.g., Virtual Teacher, CyberGlove, VR Motion, PneuGlove, Wii™).

The observational studies followed patients in treatment to monitor changes over time. The randomized trials – considered more scientifically rigorous – randomly assigned two groups of patients to get either standard or virtual reality therapy.

Some of the smaller studies added virtual reality or video gaming on top of conventional therapy, which Saposnik said could limit this pooled analysis by skewing results for those who received more therapy. So far, there have been no large (more than 100 patients), randomized, controlled trials that compared the combination of virtual reality with conventional physical and occupational therapy to conventional treatment alone. That kind of study is needed, Saposnik said.  

Co-author is Mindy Levin, P.T., M.Sc., Ph.D., for the Stroke Outcome Research Canada working group. Author disclosures are on the manuscript.

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position.  The association makes no representation or guarantee as to their accuracy or reliability.  The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events.  The association has strict policies to prevent these relationships from influencing the science content.  Revenues from pharmaceutical and device corporations are available at

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pjnissim replied on Sun, Apr 10 2011 3:37 PM

occupational therapists use the wii on occasion for similar purposes. really a beautiful application of video games/VR that inspires new movement in those who have had serious medical issues. great article.

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Excellent, but it does not surprise me. Many nursing homes are using the Wii for these same types of reasons.

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rapid1 replied on Mon, Apr 11 2011 12:58 AM

Hmmm; this is very interesting to me. Many of you do not know I had a very bad accident where I fell off of a highway bridge after almost being run over by a car (drunk driver I would imagine) while waking across a major freeway bridge. I was DOA on the scene and it is the reason I am partially deaf now. Either way shortly after I got out of the Hospital after 1.5 months of a coma, and 3 months inpatient rehab. I did fall 39 feet onto highway asphalt (of course into the fast lane of 85N).

I hurt many things in my body, my left wrist is fused, my right elbow was wired back together, I have a rod in my right arm as well, and am deaf in my right ear and partially in my left. There were other injuries as well. The biggest besides on of my ribs breaking and puncturing my lung (which is why I bled out and was pronounced DOA), was a right frontal hematoma or blood clot in my brain.

As I was told at the time the closest thing to this is suffering a stroke. Shortly after I was released from the hospital I got my first modern PC, and was on the internet. I played games etc as well, but I recovered exceptionally fast mentally which was related to me by my neurosurgeon as well as other doctors. So this would definitely seem very relevant to me personally. It also makes a great deal of sense to me looking at it from a patients point of view.

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^That story still gives me chills

My good friend's father had a stroke about 2 years ago. I fear he isn't doing enough therapy in his recovery, and my friend's family is pushing for homeopathy (dear lord....).  I'll tell him to push his dad on using the Wii he has

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rrplay replied on Mon, Apr 11 2011 11:02 AM

My sister had a stroke a few years ago and her hand and eye co-ordination was a bit off for a while. I could see how she was afected by her playing a bit of games like bode Miller Alpine skiing and of course Tux Racer.which when she would visit she liked to try. she is not a gamer but you guys have no idea how happy and surprised I was when on another visit after about 8 months I had her giveDoom 3 a go from some 'saved games'

how she laughed and yelled out loud and was blasting away at all the mech spider bots for about 20 seconds or so.and I knew she was back and really going to be OK again.

There is no doubt in my mind that pc gaming can be a very good thing.

On another note my sister became a great aunt this morning and I of course became a great uncle.

"Don't Panic ! 'cause HH got's your back!"

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jonation replied on Mon, Apr 11 2011 11:25 AM

the media always bastardizes video games, but the research done has shown the immensity of brain activity created by video games.

I am glad the research area isn't treating video games as just "games" anymore.

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HHGrrl replied on Mon, Apr 11 2011 11:46 PM

"I am glad the research area isn't treating video games as just "games" anymore." - I agree!

It's cool to see this type of technology being used to help people.

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