A novel fully immersive virtual reality environment for upper extremity rehabilitation in patients with stroke

Given the rising incidence of stroke, several technology‐driven methods for rehabilitation have recently been developed. Virtual reality (VR) is a promising therapeutic technology among them. We recently developed a neuroscientifically grounded VR system to aid recovery of motor function poststroke. The developed system provides unilateral and bilateral upper extremity (UE) training in a fully immersive virtual environment that may stimulate and activate mirror neurons (MNs) in the brain necessary for UE rehabilitation. Twenty‐three participants were randomized to a VR group (n = 12) to receive VR intervention (8 h within 2 weeks) plus 8‐h occupational therapy (OT) or a control group (n = 11) to receive time‐matched OT alone. Treatment effects on motor recovery and cortical reorganization were investigated using the Barthel Index (BI), Fugl‐Meyer Upper Extremity (FM‐UE), and resting‐state fMRI. Both groups significantly improved BI (P < 0.05), reflecting the recovery of UE motor function. The VR group revealed significant improvements on FM‐UE scores (P < 0.05) than the control group. Neural activity increased after the intervention, particularly in the brain areas implicating MNs, such as in the primary motor cortex. Overall, results suggested that using a neuroscientifically grounded VR system might offer additional benefits for UE rehabilitation in patients receiving OT. On the basis of the fundamental and valid neuroscience hypothesis of the mirror neurons, we have developed a novel virtual reality–based rehabilitation setting called the MNVR‐Rehab and presented the preliminary progress and results from clinical trials in this report. The MNVR‐Rehab provides an interactive, completely immersive, motivating, and customizable functional task environment with multiple training options. Clinical trials have shown that our MNVR‐Rehab is a promising rehabilitation tool that may improve the recovery of UE functional capabilities of subacute stroke patients with moderate‐to‐severe UE impairments. Highly repetitive functional tasks are encouraged to enable patients to develop motor skills and thus benefit their rehabilitation.