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Review Article
Effectiveness of virtual reality-supported exercise therapy in improving upper extremity function and activities of daily living among patients after stroke: a systematic review of randomized control trials
Priyanshi Dixit, Uma Phalswal, Nipin Kalal, Saumya P. Srivastava
Osong Public Health Res Perspect. 2024;15(3):189-200.   Published online May 24, 2024
  • 1,014 View
  • 27 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
This systematic review describes the effectiveness of virtual reality (VR)-supported exercise therapy on upper limb motor function and activities of daily living after stroke. Methods: Studies published through January 24, 2022, were identified using CINAHL, Cochrane Library, Embase, Medline, and Web of Science. Randomized control trials comparing VR treatment with conventional therapy (CT) for upper extremity rehabilitation after stroke were included. Methodological quality was assessed using the Cochrane risk-of-bias tool. Results: Of 9 included studies, 5 concluded that the VR group outperformed control participants, 1 indicated the superiority of VR-supported exercises alone over CT, and 3 found VR comparable to CT in promoting upper limb motor function. Five studies analyzed independence in daily living, with 4 reporting no significant difference between VR and CT groups. No strong evidence indicated long-term benefits of VR-assisted exercise. All included studies demonstrated low risk of bias concerning random sequence generation, allocation concealment, outcome assessment blinding, incomplete outcome data, and selective reporting bias. However, a high risk of bias was observed regarding participant blinding due to the nature of the intervention. Conclusion: Most studies suggested that VR, used alongside CT, can improve motor function following stroke. However, the evidence was insufficient to conclude that VR outperforms conventional approaches.
Original Articles
Effects of activities of daily living-based dual-task training on upper extremity function, cognitive function, and quality of life in stroke patients
Hee-Su An, Deok-Ju Kim
Osong Public Health Res Perspect. 2021;12(5):304-313.   Published online September 13, 2021
  • 11,315 View
  • 324 Download
  • 5 Web of Science
  • 6 Crossref
AbstractAbstract PDFSupplementary Material
The aim of this study was to investigate the effect of daily living dual-task training focused on improving attention and executive function of the upper extremities, cognitive function, and quality of life in stroke patients.
We included 30 stroke patients who were hospitalized between July 2020 and October 2020. They were divided into experimental and control groups through randomization. The experimental group performed 20 minutes of dual-task training and received 10 minutes of conventional occupational therapy, while the control group performed 20 minutes of single-task training and received 10 minutes of conventional occupational therapy. Both groups underwent their respective rehabilitation for 30 minutes per session, 5 times per week for 5 weeks.
Both groups showed significant improvements in upper extremity function, cognitive function, and quality of life; the experimental group showed higher results for all items. A significant between-group difference was observed in the magnitude of the changes.
In stroke patients, dual-task training that combined attention and executive function with daily living activities was found to be meaningful, as it encouraged active participation and motivation. This study is expected to be used as a foundation for future interventions for stroke patients.


Citations to this article as recorded by  
  • Occupation-based interventions to improve occupational performance and participation in the hospital setting: a systematic review
    Gemma Wall, Stephen Isbel, Louise Gustafsson, Claire Pearce
    Disability and Rehabilitation.2024; 46(13): 2747.     CrossRef
  • Intervention and assessment of executive dysfunction in patients with stroke: A scoping review
    Katsuya Sakai, Yuichiro Hosoi, Junpei Tanabe, Kathleen Bennett
    PLOS ONE.2024; 19(2): e0298000.     CrossRef
  • Activities of daily living interventions on activity performance of inpatients post-stroke: A systematic review and meta-analysis
    Elyse Triantis, Karen PY Liu
    British Journal of Occupational Therapy.2024;[Epub]     CrossRef
  • Motor control and working memory in adults with neurological injuries: search neuropsychological and electrophysiological evidence of cognitive-motor interaction
    Julio Ernesto Pérez-Parra, Francia Restrepo-de-Mejía
    Human Movement.2024; 25(2): 114.     CrossRef
  • The effect of five activities daily living on improving cognitive function in ischemic stroke patients
    Frana Andrianur, Dwi Prihatin Era, Arifin Hidayat, Ismansyah Ismansyah, Diah Setiani
    Healthcare in Low-resource Settings.2023;[Epub]     CrossRef
  • Effect of Upper Limb Motor Rehabilitation on Cognition in Parkinson’s Disease: An Observational Study
    Valentina Varalta, Elisa Evangelista, Anna Righetti, Giovanni Morone, Stefano Tamburin, Alessandro Picelli, Cristina Fonte, Michele Tinazzi, Ilaria Antonella Di Vico, Andreas Waldner, Mirko Filippetti, Nicola Smania
    Brain Sciences.2022; 12(12): 1684.     CrossRef
The Effects of Task-Oriented Circuit Training Using Rehabilitation Tools on the Upper-Extremity Functions and Daily Activities of Patients with Acute Stroke: A Randomized Controlled Pilot Trial
Jong-Hoon Moon, Kyoung-Young Park, Hee-Jin Kim, Chang-Ho Na
Osong Public Health Res Perspect. 2018;9(5):225-230.   Published online October 31, 2018
  • 6,441 View
  • 153 Download
  • 10 Crossref
AbstractAbstract PDF

The purpose of this study was to investigate the effect of task-oriented circuit training (TOCT) using the rehabilitation tools for upper extremity function upon the daily life of patients with acute stroke.


Eighteen patients with acute stroke were randomly allocated into either the experimental group or the control group. The experimental group performed the TOCT program using rehabilitation tools, whilst the control group had neuro-developmental treatment. Both groups received 30 minutes of treatment per session, 5~6 times per week, for 4 weeks. The assessments conducted were the Fugl-Meyer assessment, motor activity log and stroke impact scale to compare the upper extremity function and activities of daily living.


The results showed a significant improvement in the TOCT group compared with the neuro-developmental treatment group in the amount of motor activity use and high stroke impact score, indicating recovery (p < 0.05).


The TOCT program using rehabilitation tools could have a positive impact on acute stroke patients use of their upper extremity.


Citations to this article as recorded by  
  • Adaptation and clinical application of assistive device chair for bedside sitting in acute stroke phase: two case reports
    Priscila Salge Mauad Rodrigues, Marcos Massao Shimano, Edimar de Oliveira, Fábio Masao Kawamura, Ana Flávia Silveira, Gustavo José Luvizutto, Luciane Aparecida Pacucci Sande de Souza
    Disability and Rehabilitation: Assistive Technolog.2024; 19(4): 1272.     CrossRef
  • What is Task-Oriented Training? A Scoping Review
    Erin Halford, Samantha Jakubiszak, Kassidy Krug, Amanda Umphress
    Student Journal of Occupational Therapy.2024; 4(1): 1.     CrossRef
  • Evaluating the integration of traditional gong methods in smart home environment for the recovery of health functions of stroke patients
    Baoliang Wang, Hongping Su, Xiaoqian Luo, Luqiang Yin
    Journal of Intelligent & Fuzzy Systems.2024; : 1.     CrossRef
  • Dosages of Swallowing Exercises Prescribed in Stroke Rehabilitation: A Medical Record Audit
    Jacinda Choy, Fereshteh Pourkazemi, Caitlin Anderson, Hans Bogaardt
    Dysphagia.2023; 38(2): 686.     CrossRef
  • Bobath therapy is inferior to task-specific training and not superior to other interventions in improving arm activity and arm strength outcomes after stroke: a systematic review
    Simone Dorsch, Cameron Carling, Zheng Cao, Emma Fanayan, Petra L Graham, Annie McCluskey, Karl Schurr, Katharine Scrivener, Sarah Tyson
    Journal of Physiotherapy.2023; 69(1): 15.     CrossRef
  • Development and Implementation of a New Model of Care for Patients With Stroke, Acute Hospital Rehabilitation Intensive SErvices
    Nicole Langton-Frost, Stephanie Orient, Jessica Adeyemo, Mona N. Bahouth, Kelly Daley, Bingqing Ye, Annette Lavezza, April Pruski
    American Journal of Physical Medicine & Rehabilita.2023; 102(2S): S13.     CrossRef
  • Standardized circuit class group training versus individualized goal-directed group training to improve upper limb function in stroke survivors during in-patient rehabilitation: a pragmatic trial
    S.G Rozevink, C.M Beerepoot, C.K van der Sluis, J.M Hijmans
    Disability and Rehabilitation.2023; : 1.     CrossRef
  • Effects of the different intensities of task-oriented training on the upper extremity motor function and self-care ability of stroke survivors: study protocol for a multiarm parallel-group randomised controlled trial in a tertiary hospital in China
    Shengfeng Liu, Kai Zhang, Xuecha Li, Chunxiang Li, Mengsi Peng
    BMJ Open.2023; 13(12): e074106.     CrossRef
  • Revisiting dose and intensity of training: Opportunities to enhance recovery following stroke
    Kalita Donnellan-Fernandez, Andrew Ioakim, Brenton Hordacre
    Journal of Stroke and Cerebrovascular Diseases.2022; 31(11): 106789.     CrossRef
  • Effect of Task Oriented Training on Spasticity in Post Stroke Individuals
    Tanavi S. Patel, Suraj Kanase
    Journal of Ecophysiology and Occupational Health.2021; 21(3): 90.     CrossRef

PHRP : Osong Public Health and Research Perspectives