Effects of Ecologically Valid VR Task-Oriented Exercises on Post-Stroke Motor and Cognitive Function

Why is this study being done? After a stroke, many people have problems with movement, such as walking, balance, and using their arms and hands. They may also experience difficulties with thinking skills, including attention, memory, and problem-solving. These movement and thinking abilities work closely together during everyday activities, such as preparing a meal, shopping, or moving safely through the home. Traditional rehabilitation often treats movement and thinking problems separately. However, difficulties with attention, planning, and decision-making can affect a person's ability to move safely and learn new motor skills. Because of this, rehabilitation approaches that train both movement and thinking skills at the same time may provide greater benefits. Virtual reality (VR) technology can create realistic, interactive environments that allow people to practice everyday activities in a safe setting. However, there is limited research on VR programs that simultaneously challenge both movement and thinking skills, and little is known about whether any benefits last over time. What is the purpose of this study? The purpose of this study is to compare a virtual reality-based rehabilitation program that combines movement and cognitive training in realistic everyday environments with conventional occupational therapy. The study will evaluate whether the VR program leads to greater improvements in motor function and cognitive function after stroke and whether these improvements are maintained over the long term.

Inclusion Criteria: * Diagnosis of stroke confirmed by computed tomography or magnetic resonance imaging * Chronicity \> six months * Ausence of severe cognitive deficits (Mini-Mental State Examination \> 23) * Ability to stand safely and without assistance * No or minimal muscle tone (Modified Ashworth Scale \< 3). Exclusion Criteria: * Severe visual or hearing deficits * Unilateral spatial neglect * Ataxia * Orthopedic abnormalities * Lower limb pain syndrome or peripheral nerve injury affecting the lower limbs.