Wrist Rehabilitation System Using Augmented Reality for Hemiplegic Stroke Patient Rehabilitation: A Feasibility Study

Objective: Our objective was to investigate the effect of the rehabilitation system using augmented reality (AR) on upper extremity motor performance of patients with stroke. Methods: The system using AR applying mirror therapy mechanism provides the intervention protocol for the patient with hemiplegia after stroke. The system consists of a patient positioning tool (a chair), a white surface table, an image acquisition unit, an image processing unit, an image displaying unit, an arm holder, a Velcro-strap, and two blue circle stickers. To assess the feasibility of our system in motor function recovery, a stroke patient was recruited to receive the AR intervention. The treatment was performed two times a day for ten minutes over two weeks (ten days of treating weeks), except for the time of installation, calibration, and three minute breaks. Jebsen Taylor hand function test and Arm Motor Fugl-Meyer assessment were used as primary and secondary outcome measures, respectively, to evaluate the effect of motor function recovery. Additionally, stroke impact scale, Korean version-Modified Barthel Index (K-MBI), active range of motion of wrist joint (ROM), and the grasp force in Newtons were measured. Participants' feedback and adverse effects were recorded as well. Results: Motor function improvements were exhibited in wrist and hand subtest of Arm Motor Fugl-Meyer (baseline: 19; post-intervention: 23), proximal arm subtest of Fugl-Meyer (baseline: 31; post-intervention: 34), ROM (extending ROM: 10 degrees and 3 degrees for flexion and extension, repeatedly), stroke impact scale (baseline: 46; post-intervention: 54), K-MBI (baseline: 92; post-intervention: 95), nine-hole pegboard (baseline: 30 s; post-intervention: 25 s), and grasp force in Newtons (baseline: 12.7; post-intervention: 17.7). However, the adverse effects were reported after the intervention. Conclusion: The system using AR applying mirror therapy mechanism demonstrated the feasibility in motor function recovery for the stroke patient.