1000 Section - Virtual Reality-Based Home Telerehabilitation for Upper Extremity in Stroke Patients: A Pilot Study

Objectives : This pilot study aimed to investigate the feasibility and preliminary effectiveness of a home-based upper extremity telerehabilitation program delivered through a virtual reality (VR)-based system in individuals with stroke.

Design: This single-group, repeated-measures pilot study was conducted at two rehabilitation centers. Participants completed a 4-week home-based upper extremity training program using the RAPAEL Smart Board (Neofect Co., Ltd., Republic of Korea). Training was performed 5 times/week for 30 minutes per session, for a total of 20 sessions. All sessions were conducted at home, with once-weekly real-time supervision via live video by a therapist to monitor performance, ensure adherence. Outcome measures were assessed at baseline, immediately after the intervention, and at 4-week follow-up. Primary outcomes included the Fugl-Meyer Assessment (FMA) and Action Research Arm Test (ARAT). Secondary outcomes comprised the Stroke Impact Scale (SIS), Korean version of the Modified Barthel Index (KMBI), and upper limb range of motion (ROM). Changes over time were analyzed using repeated-measures ANOVA with post-hoc pairwise comparisons.
 

Results: Nine male stroke patients completed the program. Significant time effects were found for the FMA total score, ARAT, and shoulder extension ROM (p < 0.05). The proximal and distal FMA subscores showed trends toward improvement without statistical significance. No significant changes were observed in SIS domains, KMBI, or other ROM measures. Post-hoc analysis revealed that the FMA total score improved from pre-intervention to follow-up, ARAT increased from pre- to post-intervention, and shoulder extension ROM improved in all pairwise comparisons (p < 0.05). These findings indicate selective gains in upper limb motor performance and shoulder mobility, with partial maintenance at follow-up.

 

Conclusion: This pilot study demonstrates that a VR-based home telerehabilitation program is a feasible intervention for stroke survivors and can produce improvements in upper limb motor function and shoulder mobility.