Virtual reality and non-invasive brain stimulation in stroke: How effective is their combination for upper limb motor improvement?

Sandeep Subramanian, Shreya Prasanna

Research output: Chapter in Book/Report/Conference proceedingConference contribution

5 Scopus citations

Abstract

Upper limb (UL) hemiparesis is frequently a disabling consequence of stroke. The ability to improve UL functioning is associated with motor relearning and experience dependent neuroplasticity. Interventions such as non-invasive brain stimulation (NIBS) and task-practice in virtual environments (VEs) can influence motor relearning as well as adaptive plasticity. However, the effectiveness of a combination of NIBS and task-practice in VEs on UL motor improvement has not been systematically examined. The objective of this review was to examine the evidence regarding the effectiveness of combining NIBS with task-practice in VEs on UL motor impairment and activity levels. A systematic review of the published literature was conducted using standard methodology. Study quality was assessed using the PEDro scale and Down's and Black checklist. Four studies examining the effects of a combination of NIBS (involving transcranial direct current stimulation; tDCS and repetitive transcranial magnetic stimulation; rTMS) were retrieved. Of these, three studies were randomized controlled trials (RCTs) and one was a cross-sectional study. There was 1a level evidence that the combination of NIBS and task-practice in a VE was beneficial in the sub-acute stage. A combination of training in a VE with rTMS as well as tDCS was beneficial for motor improvements in the UL in sub-acute stage of stroke (1b level). The combination was not found to be superior compared to task practice in VEs alone in the chronic stage (1b level). The results suggest that people with stroke may be capable of improving levels of motor impairment and activity in the sub-acute stage if their rehabilitation program involves a combination on NIBS and VE training. Emergent questions regarding the use of more sensitive outcomes, different types of stimulation parameters, locations and training environments still need to be addressed.

Original languageEnglish (US)
Title of host publication2017 International Conference on Virtual Rehabilitation, ICVR 2017
PublisherInstitute of Electrical and Electronics Engineers Inc.
ISBN (Electronic)9781509030538
DOIs
StatePublished - Aug 10 2017
Event2017 International Conference on Virtual Rehabilitation, ICVR 2017 - Montreal, Canada
Duration: Jun 19 2017Jun 22 2017

Publication series

NameInternational Conference on Virtual Rehabilitation, ICVR
Volume2017-June
ISSN (Electronic)2331-9569

Conference

Conference2017 International Conference on Virtual Rehabilitation, ICVR 2017
Country/TerritoryCanada
CityMontreal
Period6/19/176/22/17

Keywords

  • Cerebrovascular accident
  • rTMS
  • tDCS
  • task-practice

ASJC Scopus subject areas

  • Electrical and Electronic Engineering
  • Computer Networks and Communications

Fingerprint

Dive into the research topics of 'Virtual reality and non-invasive brain stimulation in stroke: How effective is their combination for upper limb motor improvement?'. Together they form a unique fingerprint.

Cite this