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Trials. 2019 Jun 7;20(1):333. doi: 10.1186/s13063-019-3438-9.

Home-based virtual reality training after discharge from hospital-based stroke rehabilitation: a parallel randomized feasibility trial.

Author information

1
Bruyère Research Institute, 43 Bruyère St., Ottawa, ON, K1N 5C8, Canada.
2
School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Guindon Hall, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
3
Bruyère Continuing Care, 43 Bruyère St., Ottawa, ON, K1N 5C8, Canada.
4
Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine, University of Ottawa, 505 Smyth Rd., Ottawa, ON, K1H 8M2, Canada.
5
School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Cres., Ottawa, ON, K1G 5Z3, Canada.
6
University of Ottawa Heart Institute, 40 Ruskin St., Ottawa, ON, K1Y 4W7, Canada.
7
Institute for Clinical Evaluative Sciences (ICES), uOttawa, Ottawa Hospital, Civic Campus, 1053 Carling Ave., Box 684, Administrative Services Building, 1st Floor, Ottawa, ON, K1Y 4E9, Canada.
8
Bruyère Continuing Care, 43 Bruyère St., Ottawa, ON, K1N 5C8, Canada. hfinestone@bruyere.org.
9
Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine, University of Ottawa, 505 Smyth Rd., Ottawa, ON, K1H 8M2, Canada. hfinestone@bruyere.org.
10
Élisabeth Bruyère Hospital, 43 Bruyère St., Ottawa, ON, K1N 5C8, Canada. hfinestone@bruyere.org.

Abstract

BACKGROUND:

Virtual reality training (VRT) uses computer software to track a user's movements and allow him or her to interact with a game presented on a television screen. VRT is increasingly being used for the rehabilitation of arm function, balance and walking after stroke. Patients often require ongoing therapy post discharge from inpatient rehabilitation. Outpatient therapy may be limited or inaccessible due to waiting lists, transportation issues, distance etc.; therefore, home-based VRT could provide the required therapy in a more convenient and accessible setting. The objectives of this parallel randomized feasibility trial are to determine (1) the feasibility of using VRT in the home post stroke and (2) the feasibility of a battery of quantitative and qualitative outcome measures of stroke recovery.

METHODS:

Forty patients who can stand for at least 2 min and are soon to be discharged from inpatient or outpatient rehabilitation post stroke are being recruited in Ottawa, Canada and being randomized to control and experimental groups. Participants in the experimental group use home-based VRT to do rehabilitative exercises for standing balance, stepping, reaching, strengthening and gentle aerobic fitness. Control group participants use an iPad with apps selected to rehabilitate cognition, hand fine motor skills and visual tracking/scanning. Both groups are instructed to perform 30 min of exercise 5 days a week for 6 weeks. VRT intensity and difficulty are monitored and adjusted remotely. Weekly telephone contact is made with all participants. Ability to recruit participants, ability to handle the technology and learn the activities, compliance, safety, enjoyment, perceived efficacy and cost of program delivery will be assessed. A battery of assessments of standing balance, gait and community integration will be assessed for feasibility of completion within this population and potential for improvement following the intervention. Effect sizes will be calculated.

DISCUSSION:

The results of this study will be used to support the creation of a definitive randomized controlled trial on the efficacy of home-based VRT for rehabilitation post stroke.

TRIAL REGISTRATION:

ClinicalTrials.gov, NCT03261713 . Registered on 21 August 2017. Registration amended on 1 June 2018 to decrease enrollment from 40 to 20 due to a cut in study funding and difficulty recruiting participants.

KEYWORDS:

Rehabilitation; Stroke; Technology; Telerehabilitation; Virtual reality

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