A pilot study for development of shoulder proprioception training system using virtual reality for patients with stroke: The effect of manipulated visual feedback

Abstract

The shoulder can control the range of motion of upper-limb. However, proprioception declines of shoulder of patients with stroke have affected the control of upper-limb motion. The motor learning regulates body movement posture by integrating the proprioception feedback (muscle force, joint position, etc.) as well as exteroceptive feedback (vision, audition). Proprioception feedback plays important role in the motor learning. Virtual reality (VR) is able to provide an environment which manipulates visual feedback of movement of stroke patients. In this study, we developed a system that can provide the continuous matching angle task with manipulating visual feedback using virtual reality for shoulder proprioception training of patients with stroke. Nineteen patients with stroke (age: 58.16 ± 12.27 years, onset: 40.16 ± 49.76 months, males: 17, females: 2) were recruited for this experiment. Participants performed the angle matching task and continuous matching angle task. In the results, error angle of angle matching task were not different between the first half of angle matching task and the second half of angle matching task (p = 0.202). Accumulated error angle of continuous matching angle task were more reduced in the second half of continuous matching angle task than in the first half of continuous matching angle task (p = 0.002). These results are similar to the result from a study assessing balance training using vision cue deprivation. It can be explained that manipulated visual feedback using virtual reality affects the proprioception of shoulder of patients with stroke. As conclusion, we found that visual feedback manipulation using virtual reality could provide an effective proprioception feedback for proprioception training of shoulder of patients with stroke.