Home-based -Virtual Reality Intervention for Stroke Rehabilitation (Home-VR)

On-going rehabilitation is needed to maintain and improve the weaker upper extremity following stroke. Community rehabilitation programs for stroke individuals in the chronic stage are often difficult to be implement. Consequently, many individuals remain without structured interventional programs. Self-training programs, where individuals can independently continue to exercise at home, might answer this challenge. However, since exercising alone is boring and not motivating, individuals often stop the prescribed exercises and remain inactive. The use of video-games for self-training might answer this challenge. Therefore, the investigators aimed to assess the feasibility of using video-games for self-training after stroke. Specifically the investigators aim to compare the (1) training time, (2) satisfaction and (3) effectiveness of a self-training program using video-games compared to a traditional self-training program.

This is a single-blind randomized controlled trial with four assessments; two before and two following the 5-week self training intervention. Individuals are requested to perform the self training (video-games or traditional exercises) 60 minutes a day for 5 weeks.

Participants will receive a video-game console and will be asked to play video-games for one hour a day X 6 days a week for 5 weeks.

Participants will receive a manual and kit of a traditional self-training program and will be asked to perform the program one hour a day X 6 days a week for 5 weeks.

Individuals will receive a video-game console and will be taught how to play the games. They will be requested to play 60 minutes a day for 5 weeks.

Individuals will receive a manual and equipment and will be taught how to perform the exercises. They will be requested to perform the exercises 60 minutes a day for 5 weeks.

Self-training time for the 5-week program as documented on a daily log sheet by the participants in both self-training programs. The mean weekly training hours per week will also be calculated.

Change in daily use of the weaker upper extremity by using the MAL. This self-report questionnaire generates two seperate scores ranging from 0 to 5, regarding the amount and quality of the weaker upper extremity

For each daily session participants rated their perceived exertion (6-20 on the Borg scale). A mean score will be calculated per week.

Satisfaction from the 5-week program and their perceived benefit from the program for improving their weaker upper extremity and balance on a 5-point Likert scale from "not at all" to "very much".

Inclusion Criteria: 6 to 36 months after stroke onset lived in the community with family or a caregiver mild to moderate weakness the affected upper extremity without significant cognitive deficit able to walk at least 10-meters (with or without assistance). Exclusion Criteria: Other neurological conditions Epilepsy