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- Title
Combining levodopa and virtual reality-based therapy for rehabilitation of the upper limb after acute stroke: pilot study Part II.
- Authors
Samuel, Geoffrey Sithamparapillai; Oey, Nicodemus Edrick; Min Choo; Han Ju; Wai Yin Chan; Kok, Stanley; Yu Ge; Van Dongen, Antonius M.; Yee Sien Ng; Oey, Nicodemus Eldrick; Choo, Min; Ju, Han; Chan, Wai Yin; Ge, Yu; Ng, Yee Sien
- Abstract
<bold>Introduction: </bold>This study aimed to evaluate the safety and efficacy of a combination of levodopa and virtual reality (VR)-based therapy for the enhancement of upper limb recovery following acute stroke.<bold>Methods: </bold>This was a pilot single-blinded case series of acute stroke patients with upper extremity hemiparesis. Patients were randomised to standard care with concomitant administration of either levodopa alone (control group) or combination therapy consisting of VR-based motivational visuomotor feedback training with levodopa neuromodulation (VR group). Main clinical outcome measures were the Fugl-Meyer Upper Extremity (FM-UE) assessment and Action Research Arm Test (ARAT). Kinematic measurements of affected upper limb movement were evaluated as a secondary measure of improvement.<bold>Results: </bold>Of 42 patients screened, four patients were enrolled in each of the two groups. Two patients dropped out from the control group during the trial. Patients receiving combination therapy had clinically significant improvements in FM-UE assessment scores of 16.5 points compared to a 3.0-point improvement among control patients. Similarly, ARAT scores of VR group patients improved by 15.3 points compared to a 10.0-point improvement in the control group. Corresponding improvements were noted in kinematic measures, including hand-path ratio, demonstrating that the quality of upper limb movement improved in the VR group.<bold>Conclusion: </bold>Our results suggest that VR-based therapy and pharmacotherapy may be combined for acute stroke rehabilitation. Bedside acquisition of kinematic measurements allows accurate assessment of the quality of limb movement, offering a sensitive clinical tool for quantifying motor recovery during the rehabilitation process after acute stroke.
- Subjects
STROKE patients; DOPA; VIRTUAL reality therapy; ARM physiology; MEDICAL rehabilitation; HEMIPARESIS; BODY movement; THERAPEUTICS; DOPAMINE; PHYSIOLOGY of the anatomical extremities; DOPAMINE agents; STROKE treatment; COMPARATIVE studies; COMPUTER simulation; HEMIPLEGIA; KINEMATICS; RESEARCH methodology; MEDICAL cooperation; RESEARCH; STROKE; PILOT projects; EVALUATION research; RANDOMIZED controlled trials; TREATMENT effectiveness; BLIND experiment; ACUTE diseases
- Publication
Singapore Medical Journal, 2017, Vol 58, Issue 10, p610
- ISSN
0037-5675
- Publication type
journal article
- DOI
10.11622/smedj.2016111