Background: After a stroke, experts recommend regular monitoring and kinematic assessments of patients to objectively measure motor recovery. With the rise of new technologies and increasing needs for neurorehabilitation, an interest in virtual reality has emerged. In this context, we have developed an immersive virtual reality version of the Box and Block Test (BBT-VR). The aim of this study was to assess the concurrent validity of the BBT-VR among patients with stroke and healthy participants. Methods: Twenty-three healthy participants and 22 patients with stroke were asked to perform the classical Box and Block Test (BBT) and BBT-VR three times with both hands. Concurrent validity was assessed through correlations between these two tests and reliability of the BBT-VR through correlation on test–retest. Usability of the BBT-VR was also evaluated with the System Usability Scale. Hand kinematic data extracted from controller’s 3D position allowed to compute mean velocity (V_mean), peak velocity (V_peak) and smoothness (SPARC). Results: Results showed strong correlations between the number of blocks displaced with the BBT and the BBT-VR among patients with stroke for affected (r = 0.89; p < 0.001) and less-affected hands (r = 0.76; p < 0.001) and healthy participants for dominant (r = 0.58; p < 0.01) and non-dominant hands (r = 0.68; p < 0.001). Reliability for test–retest was excellent (ICC > 0.8; p < 0.001) and usability almost excellent (System Usability Scale = 79 ± 12.34%). On average participants moved between 30 and 40% less blocks during the BBT-VR than during the BBT. Healthy participants demonstrated significantly higher kinematic measures (V_mean = 0.22 ± 0.086 ms⁻¹; V_peak = 0.96 ± 0.341 ms⁻¹; SPARC = − 3.31 ± 0.862) than patients with stroke (V_mean = 0.12 ± 0.052 ms⁻¹; V_peak = 0.60 ± 0.202 ms⁻¹; SPARC = − 5.04[− 7.050 to − 3.682]). Conclusion: The BBT-VR is a usable, valid and reliable test to assess manual dexterity, providing kinematic parameters, in a population of patients with stroke and healthy participants. Trial registration http://www.clinicaltrials.gov; Unique identifier: NCT04694833, Date of registration: 11/24/2020

Context: This review aimed to synthesize the literature on the acceptability, feasibility, and effectiveness of immersive virtual technologies to promote physical exercise in older people. Method: We performed a literature review, based on four databases (PubMed, CINAHL, Embase, and Scopus; last search: 30 January 2023). Eligible studies had to use immersive technology with participants aged 60 years and over. The results regarding acceptability, feasibility, and effectiveness of immersive technology-based interventions in older people were extracted. The standardized mean differences were then computed using a random model effect. Results: In total, 54 relevant studies (1853 participants) were identified through search strategies. Concerning the acceptability, most participants reported a pleasant experience and a desire to use the technology again. The average increase in the pre/post Simulator Sickness Questionnaire score was 0.43 in healthy subjects and 3.23 in subjects with neurological disorders, demonstrating this technology’s feasibility. Regarding the effectiveness, our meta-analysis showed a positive effect of the use of virtual reality technology on balance (SMD = 1.05; 95% CI: 0.75–1.36; p < 0.001) and gait outcomes (SMD = 0.7; 95% CI: 0.14–0.80; p < 0.001). However, these results suffered from inconsistency and the number of trials dealing with these outcomes remains low, calling for further studies. Conclusions: Virtual reality seems to be well accepted by older people and its use with this population is feasible. However, more studies are needed to conclude its effectiveness in promoting exercise in older people.

Background. Due to an increasing stroke incidence, a lack of resources to implement effective rehabilitation and a significant proportion of patients with remaining impairments after treatment, there is a rise in demand for effective and prolonged rehabilitation. Development of self-rehabilitation programs provides an opportunity to meet these increasing demands. Objective. The primary aim of this meta-analysis was to determine the effect of self-rehabilitation on motor outcomes, in comparison to conventional rehabilitation, among patients with stroke. The secondary aim was to assess the influence of trial location (continent), technology, time since stroke (acute/subacute vs chronic), dose (total training duration > vs ≤ 15 hours), and intervention design (self-rehabilitation in addition/substitution to conventional therapy) on effect of self-rehabilitation. Methods. Studies were selected if participants were adults with stroke; the intervention consisted of a self-rehabilitation program defined as a tailored program where for most of the time, the patient performed rehabilitation exercises independently; the control group received conventional therapy; outcomes included motor function and activity; and the study was a randomized controlled trial with a PEDro score ≥5. Results. Thirty-five trials were selected (2225 participants) and included in quantitative synthesis regarding motor outcomes. Trials had a median PEDro Score of 7 [6–8]. Self-rehabilitation programs were shown to be as effective as conventional therapy. Trial location, use of technology, stroke stage, and intervention design did not appear to have a significant influence on outcomes. Conclusion. This meta-analysis showed low to moderate evidence that self-rehabilitation and conventional therapy efficacy was equally valuable for post-stroke motor function and activity.

Although guidelines are established for performing the six-minute walking test (6MWT), it is not always possible to implement this test in any setting, due to physical and space limitations. Yet, variations in the conditions of the test could be responsible for heterogeneous outcomes. However, the impact of the condition of the 6MWT is not clearly established in literature. The objective is to determine the influence of different implementation conditions on the validity of the 6MWT. Seventeen articles were retained after a literature review, including 597 participants. Seven articles mention that performing the test on a predetermined short back-and-forth pathway led to lower performance than when the test was performed on pathways of greater distances. The walking distance covered on a rectangular path or on a 10-m eight-form path is greater than with the back and forth on a five- to ten-meter path. Seven articles suggest that the performance achieved on a treadmill is generally lower than that obtained while walking on the ground. Evidence shows that the conditions while performing the 6MWT significantly influence the score, hence the validity of the results. The use of a ground pathway, comprising the longest linear distance possible, seems critical to ensure good validity.