Application of virtual reality technologies in the rehabilitation of patients with left and right hemisphere lesions in the acute period of ischemic stroke

Abstract

BACKGROUND: Currently, neurocognitive rehabilitation with the integration of innovative virtual reality (VR) technologies is the standard component of early rehabilitation treatment programs for patients with acute focal brain damage. AIM: Based on the statistical methodology, this study aimed to evaluate the efficiency of neurocognitive rehabilitation with the application VR technologies in patients with left and right hemisphere lesions in the acute period of ischemic stroke. MATERIALS AND METHODS: The study examined 160 patients diagnosed with ischemic stroke exhibiting cognitive impairments. Patients were divided into two groups based on stroke localization: group 1 (n=80) had left hemisphere lesions, whereas group 2 (n=80) had left hemisphere lesions. Since day 5 of hospitalization, in addition to basic therapy, rehabilitation was performed using a hardware–software multimedia complex based on VR for remote-controlled rehabilitation «Devirta-Delphi». Rehabilitation efficiency (RE) was assessed by testing objectively quantitative measures of accuracy and coordination of movement performance before and after treatment using a Kinect Delphi system. Cognitive and psychoemotional measures were assessed by neuropsychological tests on days 2–4 of hospitalization and at the end of the VR therapy. Mathematical statistics were calculated using Python programming language and its libraries Pandas and SciPy. RESULTS: Higher RE values were obtained in patients with right-sided stroke. Irrespective of lesion lateralization, significant improvement was noted with respect to mnestic, executive function, and ideomotor praxis, regression of anxiety, depression, and general aggression. Group 1 also showed an improvement in speech function and a decrease in general asthenia, whereas group 2 showed an increase in attention and emotion recognition ability. Factors that negatively affected RE were identified, namely, apathy, anxiety, prestroke cognitive decline, semantic aphasia, and decreased attention in group 1 and semantic and visual–spatial impairments, prestroke decline, and recurrent stroke in group 2. CONCLUSION: The application of an immersive environment in the early rehabilitation of patients with cognitive impairment improves the performance of verbal and visual tests reflecting mnestic, regulatory, and neurodynamic executive functions in lesions with different lateralization.