Rehabilitation add-on effect using virtual reality in patients after ischemic stroke

Author(s)

Alline Fernanda de Barros Camargo

• Document type: Master's Dissertation
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
• Defense date: 2019-08-20

Examining board members

Rodrigo Bazan; Rachel Paes Guimarães

• Advisor: Li Li Min

Abstract

Motor symptoms that affect functionality are very common after a stroke, considered a major public health problem and one of the leading causes of functional disability worldwide. The recovery will depend on the individual neuroplasticity ability, but also on their adherence, involvement and access to rehabilitation services. In this context, physiotherapy as a traditional method of rehabilitation continues to develop techniques and methods for the optimization of its results, such as virtual reality (VR) as adjuvant of the proposed treatment. This study aimed to investigate the effects of VR as an adjuvant to the treatment of conventional physiotherapy in patients with chronic ischemic stroke. Fourteen patients with chronic ischemic stroke were randomized and submitted to treatment with physiotherapy (control group) or physiotherapy plus VR (experimental group) at a frequency of twice a week over six weeks, and were evaluated before and after the intervention through the instruments: Fugl-Meyer Assessment, Berg Balance Scale, Timed Up and Go Test and Montreal Cognitive Assessment. As a complementary analysis, functional magnetic resonance imaging (3T, Phillips Achieva®) was also perform to verify the possible effects of VR on the motor network and Default Mode Network functional connectivity. A small increase in the functional connectivity between the motor network and the contralesional motor cortex was observe in the experimental group, suggesting the activation of compensatory mechanisms for cortical reorganization and a differentiated pattern of activation of functional connectivity. All patients showed gains in all variables, regardless of group, without significant differences between groups (p>0.05), and without adverse effects related to VR application, suggesting that their use as an adjuvant may generate positive effects for upper and lower limb function, gait and balance of post-stroke patients. This research provides new possibilities for investigation of non-immersive and specific VR as a rehabilitation adjuvant for post-stroke patients, also collaborating with the scientific development of physiotherapy and its domains and encouraging further research on the subject (AU)

• FAPESP's process: 16/25683-1 - Adjuvant effect of rehabilitation using virtual reality in patients after ischemic stroke
• Grantee: Alline Fernanda de Barros Camargo
• Support Opportunities: Scholarships in Brazil - Master