The objective of this paper is to determine and compare the effects of two high-intensity virtual training programs, with different frequencies and standard care after stroke. First-time ischaemic stroke patients in subacute stage were randomized into three groups: 1 session/day high-intensity virtual training (VT1; n=20), 2 sessions/day high-intensity virtual training (VT2, n=20), standard care (CON, n=20). Each group performed a 5-week-long training program (1 hour/session, 5 days/week). Results were measured before and after the interventions. Our primary outcome was the modified Rankin Scale (mRS), which indicates the degree of independence in daily activities and the severity of disability at stroke survivors. Secondary outcomes were the Barthel Index (BI), the EuroQoL Visual Analogue Scale (EQ VAS), the Berg Balance Scale (BBS), the 6-minute walking test (6mWT), the Beck Depression Inventory (BDI), and posturograpic examination in four different positions (WEO, WEC, NEO, NEC). VT2 and VT1 groups improved significantly all of the results (all p<0,05). The result of the mRS, BI, BBS, 6mWT, BDI improved significantly (all p <0.05) in CON group, but there was no clinically meaningful changes in EQ VAS, WEO, WEC, NEO, and NEC (all p>0.05).Comparing the groups’ measured 10 results: VT2 in 9 cases (mRS, BI, EQ VAS, BBS, 6mWT, BDI, WEC, NEO, NEC), VT1 in 5 cases (mRS, 6mWT, BDI, WEC, NEC) showed greater extent improvement than CON group, furthermore the improvements of mRS and BI were significantly higher at VT2, than at VT1 (all p<0.05). Our results show that the high-intensity virtual training programs could be good opportunities for subacute ischaemic stroke patients to improve their clinical symptoms, mobility, and quality of life. Furthermore, increasing daily frequency of the training, could also increase the beneficial effects. This research is particularly important because the utilized therapies have the potential to yield significant economic benefits, by reducing long-term healthcare costs and improving overall patient outcomes.

The aim of this study is to compare the effectiveness of advanced robotic therapy, virtual therapy and conventional physiotherapy in the rehabilitation of patients with acute and subacute stroke. In addition, we aim to further demonstrate the importance of an early mobilisation exercise program in the management of acute stroke patients. Participants (first-time ischaemic stroke patients in acute or subacute stages) were randomly divided into three equal groups (n=10 persons/group): a robot-assisted early mobilisation + virtual reality therapy (ROB+VR) group, a robot-assisted early mobilisation + conventional physiotherapy (ROB+FIZ) group, and a conventional physiotherapy (CON) group. Each group performed a 3-week-long training program (1 hour/session, 5 days/week). The results were measured before and after the exercise. The primary outcome measure used was the modified Rankin Scale (mRS) which indicates the severity of disability in daily activities and measures the degree of independence of the individual. The secondary outcomes were measured by the EuroQoL 5 dimensions questionnaire 5 levels version (EQ-5D-5L), the Berg Balance Scale (BBS), the Barthel Index (BI), and the 6-minute walking test (6mWT). All the three groups showed improvements in most outcomes. The scores for BI, EQ-5D-5L, and mRS showed significant improvements in quality of life. Comparing the groups, the ROB+VR group showed the greatest improvement in the scores in almost all of the tests. From the test scores, the 6-minute walk test had the highest improvement at the end of the therapy (94.58% improvement). Our results show that early robotic mobilization, followed by a movement program, combined with a virtual reality therapy, significantly improve both the speed and quality of rehabilitation after a stroke.