Telerehabilitation using a virtual environment improves upper extremity function in patients with stroke.

In this paper, we describe our experience in designing a virtual environment-based (VE) telerehabilitation system, and the results of a clinical study of the first 11 subjects with stroke to use the system. Our telerehabilitation system allows a therapist to conduct interactive VE treatment sessions remotely with a patient who is located at home. The system, software architecture, and development experience are described. Results of the clinical study on subjects with stroke showed significant improvements in upper extremity function following 30 1-h VE treatment sessions as measured by three standard clinical tests: Fugl-Meyer test of motor recovery (FM) (p < 0.0001), Wolf motor test (WMT) (p = 0.0097, and shoulder strength (ShS) (p = 0.0027). Grip strength (GS) showed a trend toward improvement (p = 0.025). These changes were maintained, for the most part, at four-months follow-up (FM +7.6, WMT -18.4 s, ShS, +169%, GS, +53%).