Participants
end-stage cancer, Stroke, cognitive impairment, trembling, stroke, function loss, upper-limb motor impairment, psychiatric, dysmetria, hemineglect
STROKE, PATHOLOGY, STROKE
The study included 46 patients (43 of whom completed the intervention period and follow-up evaluation), with a mean age of 63.1 years (SD: 12.8). Nineteen percent (n = 8) were women. The participants were recruited from the Neurology and Rehabilitation units of the Hospital General Universitario of Talavera de la Reina, and none of them suffered from moderate or severe cognitive impairment that prevented them from following verbal and visual instructions from the therapist or the SVR technology. All participants had been diagnosed with stroke and met the following inclusion criteria: (1) age between 18 and 85 years; (2) maximum time of six months since diagnosis; (3) upper-limb motor impairment (Fugl-Meyer Assessment, Ashworth Scale and ARAT); (4) dependency in ADLs (Stroke Impact Scale; version 3.0); (5) life expectancy greater than 6 months (no diagnosis of any life-threatening condition such as end-stage cancer); and (6) absence of any other serious and disabling pathology.According to baseline tests for determining motor function loss in the upper limb after stroke, we included patients who showed (1) scarce or no reflex activity, (2) absence or limitation of voluntary movements in flexion and extension synergies, (3) limitations in shoulder flexion–extension and adduction-abduction and wrist flexion–extension and stabilization, (4) difficulty grasping and gripping with the most affected hand, and (5) trembling or dysmetria (Fugl-Meyer Assessment). Furthermore, most of the patients selected for the study (especially those who had been diagnosed more than 20 days prior) showed a slight or a substantial increase in their muscle tone (Ashworth Scale) and difficulties in pinching, gripping or handling objects and making larger-scale movements, for example, placing their hand behind their head (Action Research Arm Test). We never set minimum or maximum scores for the testing tools applied; instead, we focused on movement limitations and elements that might affect the individual’s functional independence after stroke.Four exclusion criteria were defined: presence of another neurological diagnosis, severe hemineglect, psychiatric pathology, and signed revocation of informed consent [