Abstract TP357: Effect of somato-cognitive coordination therapy for acute stroke patients: a randomized controlled trial

Background: Recent technological advances including virtual reality (VR) are among the novel approaches to improve hemiplegic upper extremity (UE) functions in stroke patients. This study aimed to investigate the effect of somato-cognitive coordination therapy (SCCT) using VR on UE functions in acute stroke patients. Materials and Methods: This prospective randomized controlled trial included patients who met the following criteria: (1) confirmed diagnosis of stroke with single or multiple vascular lesions occurring within the same period; (2) Brunnstrom Recovery Stage for the UE between 2 and 5; (3) ability to sit continuously for more than 20 minutes. Twenty-two patients (mean age 72 ± 10 years; 82% male) were randomly assigned to the VR group (n=11) or control group (n=11). The VR group received both SCCT using mediVR KAGURA and standard occupational therapy (OT), while the control group received standard OT only. Interventions were performed 40 minutes per session, 5 days a week, for 2 weeks. Assessments before and after the intervention included the Fugl-Meyer Assessment UE subscale (FMA-UE), the Box and Block Test (BBT), the Motor Activity Log Amount of Use (MAL-AOU) and Quality of Movement (MAL-QOM). Baseline group differences were analyzed using the Mann-Whitney U test. Results: Nine participants in each group completed the 2-week intervention. No adverse events occurred. Baseline demographics, stroke characteristics and UE functions were comparable between groups. Both groups showed significant improvement in FMA-UE, BBT, MAL-AOU and MAL-QOM after treatment. Notably, the improvement in MAL-QOM was significantly greater in the VR group compared to the control group (p = 0.006). Although changes in FMA-UE, BBT and MAL-AOU did not reach statistical significance between groups (p = 0.77, p = 0.312, p = 0.057), the VR group showed a consistent trend toward greater improvement. Conclusions: SCCT may enhance the quality of UE movement in acute stroke patients when added to standard OT. These results support the potential of SCCT as a novel method in early stroke rehabilitation.