Smartphone-Based Semi-Immersive Virtual Reality Enhances Upper Extremity Function in Subacute Stroke: A Randomized Controlled Trial

Abstract

BackgroundUpper extremity (UE) recovery in individuals with subacute stroke often plateaus despite conventional physical therapy (CPT). Smartphone-based virtual reality (VR) represents a low-cost, semi-immersive approach that may enhance task-specific training and neuroplasticity.ObjectiveTo determine whether CPT augmented with smartphone-based VR improves UE function more than CPT alone.MethodsFifty-seven participants (28 in the experimental group and 29 in the control group) with stroke in the subacute stage (6 weeks-6 months post-stroke) and moderate UE impairment (Fugl-Meyer Assessment-Upper Extremity [FMA-UE] score 20-50) were randomized to receive either CPT plus smartphone-based VR or CPT alone, five sessions per week for six weeks. Outcomes included motor impairment (FMA-UE), activity-level dexterity (Purdue Pegboard Test), and muscle strength (grip strength).ResultsBoth groups demonstrated significant improvements (p < 0.001). The experimental group showed significantly greater improvements across all outcomes, with large effect sizes.ConclusionSmartphone-based VR providing semi-immersive, gaze-driven interaction with virtual tasks significantly enhances UE recovery and represents a scalable adjunct to rehabilitation.