Patients’ Use of a Home-Based Virtual Reality System to Provide Rehabilitation of the Upper Limb Following Stroke

A low cost, virtual reality system that translates movements of the hand, fingers and thumb into game play was created to offer a flexible and motivating approach to improving adherence to home based rehabilitation. Effectiveness depends on adherence, so did patients use the intervention to the recommended level. If not, what reasons did they give? 17 patients recovering from stroke recruited to the intervention arm of a feasibility trial had the equipment placed in their homes for eight weeks and were advised to use it three times daily for periods of no more than 20 minutes. Frequency and duration of use were automatically recorded. At the end of the intervention, participants were interviewed to determine barriers to using it in the recommended way. Duration of use and how many days they used the equipment are presented for the 13 participants who successfully started the intervention. These figures were highly variable and could fall far short of the recommendations. There was a weak (p=0.053) positive correlation between duration and baseline reported activities of daily living. Participants reported familiarity with technology and competing commitments as hindrances to use although the flexibility of the intervention was appreciated and thought to be motivating.

Level of use varies and might not meet recommendations. Competing commitments were a barrier to use of the equipment although participants reported that the intervention was flexible and motivating. It will not be suitable for everyone but some participants recorded high levels of use. Implications for practice are discussed.

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