Effects of Virtual Exercise Gaming on Upper Limb Function in Stroke Survivors

INTERVENTION: Intervention group will be equipped with Online Rehab Virtual Assistant (ORVA) for their home exercise in addition to standard treatment received in Hospital. Intervention will be performed around 30‐40 minutes per session, 5 times a week for continuous 12 weeks. ORVA is a remotely monitored system virtual reality. An application will be install in participant s or career's smartphone or tablet. Then, participants will be equipped with wrist/arm mounting strip, a micro USB cable, an Infrared (IR) sensor, and a Bluetooth Low Energy (BLE) dongle. Next, the participants and their career will attend a 1‐hour briefing by the research team at the hospital before commencing the home exercises. The ORVA games that will be used for Intervention group comprised of 3 virtual games for upper limb exercise: 1) Cube and Hole, 2)Catching and 3) Fishing. All of the games required large cursor movements in both the horizontal and vertical direction to stimulate movement of upper extremities. There are different levels of difficulty which can be set by the therapist based on participants' progress. All the progression will be assessed through the system which is connected to the application and also by the physiotherapist in the hospital. CONDITION: Physical Medicine / Rehabilitation ‐ Other physical medicine / rehabilitation Stroke ‐ Ischaemic Stroke;Poor motor function of upper limb;Poor Quality of Life; ; Stroke ; Poor motor function of upper limb ; Poor Quality of Life PRIMARY OUTCOME: Fugl‐Meyer Assessment Upper Limb section: upper limb motor function (strength, movement, coordination, and reflex action); [Baseline, week 7, week 13 (primary time point) post‐commencement of intervention] SECONDARY OUTCOME: Standardized Mini mental state examination (SMMSE): cognitive ability [Baseline, week 7, week 13 post‐commencement of intervention] Lawton Instrumental Activities of Daily Living Scale (Lawton IADL): to assess the more complex ADLs necessary for living in the community. [Baseline, week 7, week 13 post‐commencement of intervention] Wolf Motor Function Test (WMFT) : upper extremity motor ability (dexterity, strength and upper extremity function)[Baseline, week 7, week 13 post‐commencement of intervention] Stroke Impact Scale (SIS): quality of life [Baseline, week 7, week 13 post‐commencement of intervention] INCLUSION CRITERIA: i) Acute stroke survivors with impairments of upper limb (definite diagnosis of stroke that occurred less than or equal to 1 month) ii) Adults with stroke (participants had to be greater than or equal to 18 years old) iii) Adults with stroke who can participate in the virtual reality games intervention program without limitation (presently with good health and no self‐reported orthopaedic, medical or painful conditions). iv) Adults with stroke who are able to provide written informed consent.