Virtual reality training (VRT) produces the same or greater benefits as conventional rehabilitation for gait, standing balance and upper-extremity function after stroke. While patients can benefit from ongoing therapy after discharge from hospital-based rehabilitation, many do not because of availability, cost or transportation. Home-based VRT is convenient, inexpensive and motivating; therefore it may be ideal for rehabilitative exercise after discharge. Our objective was to assess the feasibility of home-based VRT for stroke patients after discharge from hospital-based rehabilitation.
Twenty participants soon-to-be discharged from hospital-based stroke rehabilitation are being randomized to VRT for standing balance/gait or an iPad with apps for fine motor and cognitive function. Both groups are requested to perform 30 minutes of activities 5 days a week for 6 weeks. Compliance and progression are tracked using on-line or manual records. Ability to use the technology, enjoyment and perceived effectiveness are assessed with a semi-structured interview post-treatment, which is coded using inductive and deductive thematic analyses.
Four participants have completed the study. Two were randomized to VRT: man age 58, 23 sessions, average 26:41 min/session; man age 46, 15 sessions, 23:49. Two were randomized to iPad: woman age 24, 27 sessions, 29:48; woman age 73, 40 sessions, 32:15. The only technical issue was one difficulty with log-in. There were no adverse effects although two participants had to limit training due to pain (frozen shoulder, gout). Participants enjoyed the VRT and iPad activities; however over time the VRT became less engaging. Both activities were perceived to be helpful for recovery.

HOME-BASED VIRTUAL REALITY TRAINING AFTER STROKE: PRELIMINARY DATA OF A TELEREHABILITATION FEASIBILITY RANDOMIZED CONTROLLED TRIAL