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Reinforcement Feedback in Virtual Environment vs. Conventional Physical Therapy for arm motor deficit after Stroke

Enhanced feedback provided by a virtual reality system has been shown to promote motor learning in normal subjects. We evaluated whether this approach could be useful for treating patients with motor deficits following brain lesions. Thirty subjects with mild to intermediate arm impairments due to stroke were selected for the study. They were randomly divided into two groups: the patients assigned to the study group received an hour of reinforced feedback in virtual-environment (RFVE) therapy daily for one month. The patients assigned to the control group received the same amount of treatment in time, consisting of traditional physical therapy (Conventional Therapy, CT). In both groups, before and after the therapy, we assessed the degree of motor impairment and autonomy in daily living activities using the Fugl-Meyer scale for the upper extremities and Functional Independence Measure, respectively. Both therapies yielded significant improvements over baseline values in the mean scores on the Fugl-Meyer Upper Extremity and Functional Independence Measure scales. These data indicate that motor recovery in post-stroke patients may be promoted by the enhanced feedback provided in a virtual environment.