Chinese Journal of Tissue Engineering Research ›› 2022, Vol. 26 ›› Issue (17): 2756-2761.doi: 10.12307/2022.547

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Virtual reality training improves motor function of the upper limbs in stroke survivors: an evaluation using transcranial magnetic stimulation

Xiao Xiang1, Huang Dongfeng2    

  1. 1Department of Rehabilitation Medicine, Luohu People’s Hospital, Shenzhen 518001, Guangdong Province, China; 2Department of Rehabilitation Medicine, Xinhua College, Sun Yat-sen University, Guangzhou 510520, Guangdong Province, China
  • Received:2021-05-06 Revised:2021-06-24 Accepted:2021-11-20 Online:2022-06-18 Published:2021-12-27
  • About author:Xiao Xiang, MD, Associate chief physician, Department of Rehabilitation Medicine, Luohu People’s Hospital, Shenzhen 518001, Guangdong Province, China
  • Supported by:
    the 2019 Teaching Reform Research Project of Guangdong Provincial Clinical Teaching Base, No. 2019JD116 (to XX)

Abstract: BACKGROUND: Motor deficits of the upper limbs after stroke may be related to a reduction in neural drive from the cortex to muscles.  
OBJECTIVE: To explore the mechanism by which virtual reality training acts on the upper limb motor function of stroke patients based on the motor evoked potentials triggered by transcranial magnetic stimulation and changes in clinical indications.
METHODS: Thirty stroke patients were recruited and randomized into two groups: an experimental group and a control group, followed by 4 weeks of virtual reality training using Kinect somatosensory interaction technology and occupational therapy, respectively. Two assessments involving Fugl-Meyer upper-extremity score, transcranial magnetic stimulation-induced motor evoked potential and game score were conducted before and after intervention. 
RESULTS AND CONCLUSION: The Fugl-Meyer upper-extremity score presented no significant difference between two groups before intervention (P > 0.05), and a significant improvement in the two groups after intervention (P < 0.05). The Fugl-Meyer upper-extremity score presented a greater improvement in the experimental group compared with the control group after intervention (P < 0.05). Game scores reflected that motion performance of each participant in the experimental group improved. Transcranial magnetic stimulation assessment showed that cortex latency and central motor conduction time were significantly reduced in the experimental group compared with the control group (P < 0.05). Whereas, there was no significant difference in the amplitude of motor evoked potential between two groups after intervention. To conclude, the virtual reality training can improve the motor function of the upper limbs in patients after stroke, which may be realized by facilitating the reconstruction of nerve conduction pathway. 

Key words: stroke, transcranial magnetic stimulation, virtual reality, motor function, upper limb, rehabilitation

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