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Soufi Ahmadi H, Hassani Mehraban A, Amini M, Sheikhi M. The Effects of Virtual Reality on Upper Limb Function in Chronic Stroke Patients: A Clinical Trial. Iranian Rehabilitation Journal 2019; 17 (1) :81-89
URL: http://irj.uswr.ac.ir/article-1-874-en.html

Objectives: Stroke is one of the main causes of disability and mortality worldwide. Most survivors experience impairments in their upper limb motor function.
Methods: This experimental study was performed as a clinical trial on 30 chronic stroke patients who experienced stroke from 6 to 96 months ago. Patients were non-randomly divided into the intervention (Virtual Reality besides conventional occupational therapy) and control (conventional occupational therapy) groups. Each treatment session lasted for one hour which was divided into conducting conventional occupational therapy techniques and Virtual Reality (VR) for the intervention group, and routine techniques for the control group. The intervention effectiveness was evaluated by the Fugl-Meyer Upper Extremity Scale, Stroke Impact Scale, Chedoke Arm and Hand Activity Inventory, Motricity Index, Modified Ashworth Scale and goniometer. Results were analyzed by SPSS and one-sample Kolmogorov-Smirnov, Shapiro-Wilk test, Independent Samples t-test and Mann Whitney U test were applied to assess the normality of data and to detect significant differences between study variables.
Results: The results suggested that investigated parameters such as upper limb motor function, muscle tone and the range of motion were significantly different in the intervention group, compared to control group; however, there was no significant changes in none of the group’s daily living activities. 
Discussion: VR-based computer games in combination with routine occupational therapy interventions could improve upper extremities functional impairments in chronic stroke patients. However, it seems the mechanisms behind the effectiveness of video games and their impact on brain cortex as well as upper limbs function need to be further investigated.