Use of client-centered virtual reality in rehabilitation after stroke: a feasibility study

• Autor(a) principal: Alberto Luis Aramaki
• Data de Publicação: 2019
• Outros Autores: Rosana Ferreira Sampaio, Alessandra Cavalcanti, Fabiana Caetano Martins Silva e Dutra
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: https://doi.org/10.1590/0004-282X20190103; http://hdl.handle.net/1843/42598; http://orcid.org/0000-0002-1740-6686; http://orcid.org/0000-0002-4775-9650; http://orcid.org/0000-0002-2306-2031; http://orcid.org/0000-0003-3295-1583
• topic: Rehabilitation; Virtual reality exposure therapy; Video games; Stroke; Patient-centered care; Acidente vascular cerebral - Reabilitação; Realidade virtual na terapia; Video games; Cuidado com os doentes

Patient-centered virtual reality (VR) programs could assist in the functional recovery of people after a stroke. Objectives: To analyze the feasibility of a rehabilitation protocol using client-centered VR and to evaluate changes in occupational performance and social participation. Methods: This was a mixed methods study. Ten subacute and chronic stroke patients participated in the rehabilitation program using games in non-immersive VR for 40 minutes/day, three days/week, for 12 weeks. Sociodemographic information was collected and the outcome variables included were the Canadian Occupational Performance Measure (COPM) and the Participation Scale. A field diary was used to record the frequency of attendance and adherence of participants and an interview was conducted at the end of program. Results: There were significant and clinically-relevant statistical improvements in the COPM performance score (p < 0.001; CI = 1.29 − 4.858) and in the COPM satisfaction score (p < 0.001; CI = 1.37 − 5.124), with a difference greater than 4.28 points for performance and 4.58 points for satisfaction. The change in the scores for participation was statistically significant (p = 0.046), but there was no clinical improvement (dcohen = −0.596, CI = −1.862 − 0.671). The majority of participants reported more than 75% consecutive attendance of sessions and there was 100% adherence to the program. In the interviews, the participants described their post-stroke difficulties; how the video game motivated their engagement in rehabilitation; and the improvement of occupational performance and social participation after participating in the program. Conclusions: VR is a viable tool for the rehabilitation of stroke patients with functional gains, mainly regarding occupational performance and performance satisfaction.