Virtual Environment Training Improves Motor Performance in Two Patients with Stroke: Case Report

Abstract

Two subjects with hemiplegia were treated using a computer-generated virtual environment (VE) to train upper extremity reach in the impaired limb. Subjects were evaluated pre- and post-VE training using motor recovery and functional ability tests and a real-world test that required reaching to 9 locations in the workspace. During VE training, subjects practiced a virtual task similar to the real task, trying to imitate a virtual teacher's performance. Post-training, reaching errors during real-world performance were reduced by ˜50% (mean across all workspace locations). Both subjects improved in the trained task, indicating transfer of skill from VE to real world performance; reaching also improved in untrained parts of the workspace, indicating some generalization of transfer. Motor recovery and functional scores showed little to no change but one subject acquired the ability to perform several functional tasks (not on the formal test). Our results suggest that VE training holds future promise for stroke rehabilitation.