Cardiovascular

Efficacy and safety of immersive, sEMG-triggered virtual reality game training for post-stroke dysphagia: a randomized, single-blind, controlled trial.

TL;DR

Immersive, sEMG-triggered VR game training may be a safe and effective adjunct to conventional swallowing therapy for improving short-term swallowing-related outcomes in patients with post-stroke dysphagia.

Key Findings

Both the experimental and control groups showed significant improvement in all swallowing outcome measures after 3 weeks of treatment.

  • Both groups showed lower WST grades, lower SSA scores, higher FOIS levels, and higher sEMG RMS values after treatment
  • All within-group improvements were statistically significant (all P < 0.05)
  • Treatment was provided 5 times per week for 3 weeks
  • The control group received conventional swallowing therapy alone; the experimental group received the same plus sEMG-triggered immersive VR game training

The experimental group achieved significantly greater gains in all outcome measures compared to the control group.

  • Between-group differences were statistically significant for WST, SSA, FOIS, and sEMG RMS values (all P < 0.05)
  • Outcomes assessed included the Kubota Water Swallowing Test (WST), Standardized Swallowing Assessment (SSA), Functional Oral Intake Scale (FOIS), and sEMG root mean square (RMS) values
  • 60 patients with PSD were randomly assigned to experimental (n = 30) or control (n = 30) groups
  • The trial was prospective, randomized, and single-blind

The total effective rate was higher in the experimental group than in the control group, with a statistically significant difference in the distribution of clinical efficacy categories.

  • Total effective rate was 86.67% in the experimental group versus 73.33% in the control group
  • The distribution of clinical efficacy categories differed significantly between the two groups (Z = 3.15, P = 0.002)
  • Clinical efficacy was assessed categorically, allowing for ordinal comparison between groups

No serious training-related adverse events occurred in either group during the study.

  • The study specifically assessed safety as part of its outcomes
  • No serious adverse events were reported in either the experimental or control group
  • This supports the safety profile of immersive sEMG-triggered VR game training as an adjunct therapy

Traditional rehabilitation for post-stroke dysphagia is often hampered by low patient adherence due to its unengaging nature, motivating the investigation of VR-based approaches.

  • Post-stroke dysphagia (PSD) is described as a common and serious complication
  • The study was designed to evaluate VR training specifically as an adjunctive therapy to address the engagement limitations of conventional swallowing therapy
  • The VR system used surface electromyography (sEMG) triggering in an immersive game-based format

What This Means

This research suggests that adding an immersive virtual reality (VR) game system to standard swallowing therapy can meaningfully improve swallowing ability in stroke patients who have difficulty swallowing (a condition called dysphagia). In the study, 60 stroke patients were split into two groups: one received conventional swallowing exercises alone, while the other received the same exercises plus VR game training that was controlled by the electrical signals from their swallowing muscles (sEMG-triggered). After three weeks of treatment five days per week, both groups improved, but the VR group improved significantly more on every measure tested, including standardized swallowing assessments and muscle activity readings. The VR group also had a higher overall treatment success rate (about 87%) compared to the conventional therapy group (about 73%), and this difference was statistically meaningful. Importantly, no serious side effects or safety concerns arose from the VR training, suggesting it can be used without significant risk. The study authors specifically designed this approach to address a well-known problem in swallowing rehabilitation — that traditional exercises can be repetitive and boring, leading patients to disengage from treatment. This research suggests that combining engaging, game-based VR technology with muscle-signal feedback could be a practical way to enhance standard swallowing rehabilitation after stroke. Because dysphagia after stroke is associated with serious complications like pneumonia and malnutrition, finding more effective therapies has important real-world implications. However, the study was short-term (3 weeks), involved a relatively small number of patients, and was conducted at a single center, so larger and longer studies would be needed to confirm these findings and determine how long the benefits last.

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Citation

Kang X, Rao W, Yang R, Chen B, Xiao Q, Xie Y, et al.. (2026). Efficacy and safety of immersive, sEMG-triggered virtual reality game training for post-stroke dysphagia: a randomized, single-blind, controlled trial.. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. https://doi.org/10.1007/s10072-026-09223-w