Virtual Reality in Occupational Therapy Upper Limb Stroke Rehabilitation

Inclusion Criteria: Stroke Participants Able to provide informed consent Aged over 18 years. Evidence of stroke confirmed by medical team Newly diagnosed patients who are admitted to the acute stroke unit with a confirmed diagnosis of stroke. More than 48 hours since stroke event Patient is appropriate to participate in rehabilitation according to the treating physician or medical consultant, and able to follow simple verbal commands. Presence of an upper limb deficit identified in the NIHSS (National Institutes of Health Stroke Scale) or by a member of the medical or multidisciplinary team Residents within the Belfast health and social care trust catchment area/postcode Staff participants: Qualified Registered Occupational Therapy Staff who work in the Stroke Unit in the Royal Victoria Hospital Belfast or in the Community Stroke Team in the Belfast Health and Social Care Trust. Able to provide informed consent Aged 18 or over Exclusion Criteria: Stroke Participants: Stroke onset more than 3 months prior to study entry. Acutely medically unwell as per medical team Patient is unable to follow verbal commands or has global aphasia. Interpreters may be used to accommodate stroke survivors' communication needs. Severe illness with a life expectancy of less than 3 months (e.g., cancer, endocarditis, metastasis with an occult primary malignancy). Uncontrolled hypertension as assessed by the treating physician. Unstable angina or recent myocardial infarction. Any history of epilepsy or seizures, except for febrile seizures of childhood. Current participation in another clinical trial involving rehabilitation (e.g., recreational therapy, occupational therapy, physiotherapy) or an investigational drug that might interfere with study results. Patient is unwilling or unable to comply with the protocol or cannot/will not cooperate fully with the investigator or study personnel. Any physical health condition, mental health condition, or other medical condition or diagnosis that might confound the interpretation of results or put the patient at risk (e.g., amputation of one extremity). History of vertigo. Active delirium/significant levels of confusion Cervical artery dissection. Patients with implanted devices such as pacemakers, defibrillators, and cochlear implants. Individual currently being managed under the Mental Capacity Act Staff participants: Uncontrolled hypertension as assessed by the treating physician. Unstable angina or recent myocardial infarction Any history of epilepsy, seizures, except for febrile seizures of childhood. Current participation in another clinical trial involving rehabilitation (e.g., recreational therapy, occupational therapy, physiotherapy) or an investigational drug that might interfere with study results. Any physical health condition, mental health condition, or other medical condition or diagnosis that might confound the interpretation of results or put the patient at risk (e.g., amputation of one extremity). History of vertigo. Cervical artery dissection. Staff members with implanted devices such as pacemakers, defibrillators, and cochlear implants.