1. Kemenkes Kesehatan RI. 2024. Cegah Stroke dengan Aktivitas Fisik. Diunduh dari https://kemkes.go.id/id/rilis-kesehatan/cegah-stroke-dengan-aktivitas-fisik diakses pada tanggal 04 April 2025.
2. Hendricks HT, Van Limbeek J, Geurts AC, Zwarts MJ. Motor recovery after stroke: a systematic review of the literature. Arch Phys Med Rehabil. 2002; 83:1629–1637.
3. Kwakkel G, Kollen BJ, van der Grond J, Prevo AJ. Probability of regaining dexterity in the flaccid upper limb: impact of severity of paresis and time since onset in acute stroke. Stroke. 2003; 34:2181–2186.
4. Desrosiers J, Malouin F, Bourbonnais D, Richards CL, Rochette A, Bravo G. Arm and leg impairments and disabilities after stroke rehabilitation: relation to handicap. Clin Rehabil. 2003; 17:666–673.
5. Mang CS, Campbell KL, Ross CJ, Boyd LA. Promoting neuroplasticity for motor rehabilitation after stroke: considering the effects of aerobic exercise and genetic variation on brain-derived neurotrophic factor. Phys Ther. 2013; 93:1707–1716.
6. Pin-Barre C, Laurin J. Physical exercise as a diagnostic, rehabilitation, and preventive tool: influence on neuroplasticity and motor recovery after stroke. Neural Plast. 2015; 2015:608581.
7. Chen A, Xiong LJ, Tong Y, Mao M. The neuroprotective roles of BDNF in hypoxic ischemic brain injury. Biomed Rep. 2013; 1:167–176. doi: 10.3892/br.2012.48.
8. Riva G, Baños RM, Botella C, Mantovani F, Gaggioli A. Transforming experience: the potential of augmented reality and virtual reality for enhancing personal and clinical change. Front Psychiatry. 2016; 7:164.
9. Germanotta M, Gower V, Papadopoulou D, Cruciani A, Pecchioli C, Mosca R, et al. Reliability, validity and discriminant ability of a robotic device for finger training in patients with subacute stroke. J Neuroeng Rehabil. 2020; 17:1.
10. Ögün MN, Kurul R, Yaşar MF, Turkoglu SA, Avci Ş, Yildiz N. Effect of leap motion-based 3D immersive virtual reality usage on upper extremity function in ischemic stroke patients. Arq Neuropsiquiatr. 2019; 77:681–688.
11. Song YH, Lee HM. Effect of immersive virtual reality-based bilateral arm training in patients with chronic stroke. Brain Sci. 2021; 11:1032.
12. Subramanian SK, Levin MF. Viewing medium affects arm motor performance in 3D virtual environments. J Neuroeng Rehabil. 2011; 8:36. doi: 10.1186/1743-0003-8-36.
13. Crosbie J, Lennon S, McGoldrick M, McNeill M, Burke J, McDonough SM, et al. Virtual reality in the rehabilitation of the upper limb after hemiplegic stroke: a randomised pilot study. Proc 7th ICDVRAT ArtAbilit. 2008; 229:235.
14. Crosbie JH, Lennon S, McGoldrick MC, McNeill MD, McDonough SM. Virtual reality in the rehabilitation of the arm after hemiplegic stroke: a randomized controlled pilot study. Clin Rehabil. 2012; 26:798–806.
15. Huang X, Naghdy F, Du H, Naghdy G, Murray G. Design of adaptive control and virtual reality-based fine hand motion rehabilitation system and its effects in subacute stroke patients. Comp Methods Biomech Biomed Eng Imaging Visual. 2018; 6:678–86.
16. Weber LM, Nilsen DM, Gillen G, Yoon J, Stein J. Immersive virtual reality mirror therapy for upper limb recovery after stroke: a pilot study. Am J Phys Med Rehabil. 2019; 98:783–788.
17. Wang, Z. R., Wang, P., Xing, L., Mei, L. P., Zhao, J., & Zhang, T. (2017). Leap Motion-based virtual reality training for improving motor functional recovery of upper limbs and neural reorganization in subacute stroke patients. Neural regeneration research, 12(11), 1823–1831.
18. Prochnow D, Bermúdez i Badia S, Schmidt J, Duff A, Brunheim S, Kleiser R, et al. A functional magnetic resonance imaging study of visuomotor processing in a virtual reality-based paradigm: rehabilitation gaming system. Eur J Neurosci. 2013; 37:1441–1447.
19. Takahashi CD, Der-Yeghiaian L, Le V, Motiwala RR, Cramer SC. Robot-based hand motor therapy after stroke. Brain. 2008; 131:425–437.
20. Jang SH, You SH, Hallett M, Cho YW, Park CM, Cho SH, et al. Cortical reorganization and associated functional motor recovery after virtual reality in patients with chronic stroke: an experimenter-blind preliminary study. Arch Phys Med Rehabil. 2005; 86:2218–2223.
21. You SH, Jang SH, Kim YH, Hallett M, Ahn SH, Kwon YH, et al. Virtual reality–induced cortical reorganization and associated locomotor recovery in chronic stroke: an experimenter-blind randomized study. Stroke. 2005; 36:1166–1171.
22. Calabrò RS, Naro A, Russo M, Leo A, De Luca R, Balletta T, et al. The role of virtual reality in improving motor performance as revealed by EEG: a randomized clinical trial. J Neuroeng Rehabil. 2017; 14:53. doi: 10.1186/s12984-017-0268-4.
23. Kang YJ, Park HK, Kim HJ, Lim T, Ku J, Cho S, et al. Upper extremity rehabilitation of stroke: facilitation of corticospinal excitability using virtual mirror paradigm. J Neuroeng Rehabil. 2012; 9:71.
24. Wlodarczyk L, Szelenberger R, Cichon N, Saluk-Bijak J, Bijak M, Miller E. Biomarkers of angiogenesis and neuroplasticity as promising clinical tools for stroke recovery evaluation. Int J Mol Sci. 2021; 22:3949.
25. Liu W, Wang X, O’Connor M, Wang G, Han F. Brain-derived neurotrophic factor and its potential therapeutic role in stroke comorbidities. Neural Plast. 2020; 2020:1969482.
26. Huang, C. Y., Chiang, W. C., Yeh, Y. C., Fan, S. C., Yang, W. H., Kuo, H. C., & Li, P. C. (2022). Effects of virtual reality-based motor control training on inflammation, oxidative stress, neuroplasticity and upper limb motor function in patients with chronic stroke: a randomized controlled trial. BMC neurology, 22(1), 21.
27. Lasek-Bal A, Jędrzejowska-Szypułka H, Różycka J, Bal W, Holecki M, Duława J, et al. Low concentration of BDNF in the acute phase of ischemic stroke as a factor in poor prognosis in terms of functional status of patients. Med Sci Monit. 2015; 21:3900–3905.
28. Wang J, Gao L, Yang YL, Li YQ, Chang T, Man MH, et al. Low serum levels of brain-derived neurotrophic factor were associated with poor short-term functional outcome and mortality in acute ischemic stroke. Mol Neurobiol. 2017; 54:7335–7342.
29. Astuti A, Sutarni S, Setyopranoto I. Serum brain-derived neurotrophic factor (BDNF) level may predict the functional outcome of acute ischemic stroke patients. Biomed Pharmacol J. 2020; 13:1963–1973.
30. Sobrino T, Rodríguez-Yáñez M, Campos F, Iglesias-Rey R, Millán M, de la Ossa NP, et al. Association of high serum levels of growth factors with good outcome in ischemic stroke: a multicenter study. Transl Stroke Res. 2020; 11:653–663.
31. Stanne TM, Åberg ND, Nilsson S, Jood K, Blomstrand C, Andreasson U, et al. Low circulating acute brain-derived neurotrophic factor levels are associated with poor long-term functional outcome after ischemic stroke. Stroke. 2016; 47:1943–1945.
32. Keci A, Tani K, Xhema J. Role of rehabilitation in neural plasticity. Open Access Macedonian J Med Sci. 2019;7(9):1540.
33. Lee KE, Choi M, Jeoung B. Effectiveness of Rehabilitation Exercise in improving physical function of Stroke patients: a systematic review. Int J Environ Res Public Health. 2022; 19:19.
34. Iosa, M., Morone, G., Fusco, A., Castagnoli, M., Fusco, F. R., Pratesi, L., & Paolucci, S. (2015). Leap motion controlled videogame-based therapy for rehabilitation of elderly patients with subacute stroke: a feasibility pilot study. Topics in stroke rehabilitation, 22(4), 306–316.
35. Smeragliuolo, A. H., Hill, N. J., Disla, L., & Putrino, D. (2016). Validation of the Leap Motion Controller using markered motion capture technology. Journal of biomechanics, 49(9), 1742–1750.
36. Mojtabavi H, Shaka Z, Momtazmanesh S, Ajdari A, Rezaei N. Circulating brain-derived neurotrophic factor as a potential biomarker in stroke: a systematic review and meta-analysis. J Transl Med. 2022 Mar 14;20(1):126.
37. Petrova LV, Kostenko EV, Martynov MY, Pogonchenkova IV, Kopasheva VD. Vliyanie reabilitatsii s sensornoi perchatkoi i virtual'noi real'nost'yu na dinamiku neirotroficheskogo faktora golovnogo mozga i kognitivnykh vyzvannykh potentsialov P300 v rannem vosstanovitel'nom periode ishemicheskogo insul'ta [The effect of rehabilitation with sensory glove and virtual reality on concentration of brain-derived neurotrophic factor and event related potential P300 in the early rehabilitation period after ischemic stroke]. Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(12. Vyp. 2):75-81.
38. Koroleva ES, Tolmachev IV, Alifirova VM, Boiko AS, Levchuk LA, Loonen AJM, Ivanova SA. Serum BDNF's Role as a Biomarker for Motor Training in the Context of AR-Based Rehabilitation after Ischemic Stroke. Brain Sci. 2020 Sep 9;10(9):623.
39. Lee HS, Lim JH, Jeon BH, Song CS. Non-immersive Virtual Reality Rehabilitation Applied to a Task-oriented Approach for Stroke Patients: A Randomized Controlled Trial. Restor Neurol Neurosci. 2020;38(2):165-172.
40. Yang SW, Ma SR, Choi JB. The Effect of Kinesio Taping Combined with Virtual-Reality-Based Upper Extremity Training on Upper Extremity Function and Self-Esteem in Stroke Patients. Healthcare (Basel). 2023 Jun 21;11(13):1813.
41. Zhang N, Wang H, Wang H, Qie S. Impact of the combination of virtual reality and noninvasive brain stimulation on the upper limb motor function of stroke patients: a systematic review and meta-analysis. J Neuroeng Rehabil. 2024 Oct 5;21(1):179.
42. Patel J, Fluet G, Qiu Q, Yarossi M, Merians A, Tunik E, Adamovich S. Intensive virtual reality and robotic based upper limb training compared to usual care, and associated cortical reorganization, in the acute and early sub-acute periods post-stroke: a feasibility study. J Neuroeng Rehabil. 2019 Jul 17;16(1):92.
43. Shen J, Gu X, Fu J, Yao Y, Li Y, Zeng M, Liu Z, Lu C. Virtual reality-induced motor function of the upper extremity and brain activation in stroke: study protocol for a randomized controlled trial. Front Neurol. 2023 Apr 17;14:1094617.
2. Hendricks HT, Van Limbeek J, Geurts AC, Zwarts MJ. Motor recovery after stroke: a systematic review of the literature. Arch Phys Med Rehabil. 2002; 83:1629–1637.
3. Kwakkel G, Kollen BJ, van der Grond J, Prevo AJ. Probability of regaining dexterity in the flaccid upper limb: impact of severity of paresis and time since onset in acute stroke. Stroke. 2003; 34:2181–2186.
4. Desrosiers J, Malouin F, Bourbonnais D, Richards CL, Rochette A, Bravo G. Arm and leg impairments and disabilities after stroke rehabilitation: relation to handicap. Clin Rehabil. 2003; 17:666–673.
5. Mang CS, Campbell KL, Ross CJ, Boyd LA. Promoting neuroplasticity for motor rehabilitation after stroke: considering the effects of aerobic exercise and genetic variation on brain-derived neurotrophic factor. Phys Ther. 2013; 93:1707–1716.
6. Pin-Barre C, Laurin J. Physical exercise as a diagnostic, rehabilitation, and preventive tool: influence on neuroplasticity and motor recovery after stroke. Neural Plast. 2015; 2015:608581.
7. Chen A, Xiong LJ, Tong Y, Mao M. The neuroprotective roles of BDNF in hypoxic ischemic brain injury. Biomed Rep. 2013; 1:167–176. doi: 10.3892/br.2012.48.
8. Riva G, Baños RM, Botella C, Mantovani F, Gaggioli A. Transforming experience: the potential of augmented reality and virtual reality for enhancing personal and clinical change. Front Psychiatry. 2016; 7:164.
9. Germanotta M, Gower V, Papadopoulou D, Cruciani A, Pecchioli C, Mosca R, et al. Reliability, validity and discriminant ability of a robotic device for finger training in patients with subacute stroke. J Neuroeng Rehabil. 2020; 17:1.
10. Ögün MN, Kurul R, Yaşar MF, Turkoglu SA, Avci Ş, Yildiz N. Effect of leap motion-based 3D immersive virtual reality usage on upper extremity function in ischemic stroke patients. Arq Neuropsiquiatr. 2019; 77:681–688.
11. Song YH, Lee HM. Effect of immersive virtual reality-based bilateral arm training in patients with chronic stroke. Brain Sci. 2021; 11:1032.
12. Subramanian SK, Levin MF. Viewing medium affects arm motor performance in 3D virtual environments. J Neuroeng Rehabil. 2011; 8:36. doi: 10.1186/1743-0003-8-36.
13. Crosbie J, Lennon S, McGoldrick M, McNeill M, Burke J, McDonough SM, et al. Virtual reality in the rehabilitation of the upper limb after hemiplegic stroke: a randomised pilot study. Proc 7th ICDVRAT ArtAbilit. 2008; 229:235.
14. Crosbie JH, Lennon S, McGoldrick MC, McNeill MD, McDonough SM. Virtual reality in the rehabilitation of the arm after hemiplegic stroke: a randomized controlled pilot study. Clin Rehabil. 2012; 26:798–806.
15. Huang X, Naghdy F, Du H, Naghdy G, Murray G. Design of adaptive control and virtual reality-based fine hand motion rehabilitation system and its effects in subacute stroke patients. Comp Methods Biomech Biomed Eng Imaging Visual. 2018; 6:678–86.
16. Weber LM, Nilsen DM, Gillen G, Yoon J, Stein J. Immersive virtual reality mirror therapy for upper limb recovery after stroke: a pilot study. Am J Phys Med Rehabil. 2019; 98:783–788.
17. Wang, Z. R., Wang, P., Xing, L., Mei, L. P., Zhao, J., & Zhang, T. (2017). Leap Motion-based virtual reality training for improving motor functional recovery of upper limbs and neural reorganization in subacute stroke patients. Neural regeneration research, 12(11), 1823–1831.
18. Prochnow D, Bermúdez i Badia S, Schmidt J, Duff A, Brunheim S, Kleiser R, et al. A functional magnetic resonance imaging study of visuomotor processing in a virtual reality-based paradigm: rehabilitation gaming system. Eur J Neurosci. 2013; 37:1441–1447.
19. Takahashi CD, Der-Yeghiaian L, Le V, Motiwala RR, Cramer SC. Robot-based hand motor therapy after stroke. Brain. 2008; 131:425–437.
20. Jang SH, You SH, Hallett M, Cho YW, Park CM, Cho SH, et al. Cortical reorganization and associated functional motor recovery after virtual reality in patients with chronic stroke: an experimenter-blind preliminary study. Arch Phys Med Rehabil. 2005; 86:2218–2223.
21. You SH, Jang SH, Kim YH, Hallett M, Ahn SH, Kwon YH, et al. Virtual reality–induced cortical reorganization and associated locomotor recovery in chronic stroke: an experimenter-blind randomized study. Stroke. 2005; 36:1166–1171.
22. Calabrò RS, Naro A, Russo M, Leo A, De Luca R, Balletta T, et al. The role of virtual reality in improving motor performance as revealed by EEG: a randomized clinical trial. J Neuroeng Rehabil. 2017; 14:53. doi: 10.1186/s12984-017-0268-4.
23. Kang YJ, Park HK, Kim HJ, Lim T, Ku J, Cho S, et al. Upper extremity rehabilitation of stroke: facilitation of corticospinal excitability using virtual mirror paradigm. J Neuroeng Rehabil. 2012; 9:71.
24. Wlodarczyk L, Szelenberger R, Cichon N, Saluk-Bijak J, Bijak M, Miller E. Biomarkers of angiogenesis and neuroplasticity as promising clinical tools for stroke recovery evaluation. Int J Mol Sci. 2021; 22:3949.
25. Liu W, Wang X, O’Connor M, Wang G, Han F. Brain-derived neurotrophic factor and its potential therapeutic role in stroke comorbidities. Neural Plast. 2020; 2020:1969482.
26. Huang, C. Y., Chiang, W. C., Yeh, Y. C., Fan, S. C., Yang, W. H., Kuo, H. C., & Li, P. C. (2022). Effects of virtual reality-based motor control training on inflammation, oxidative stress, neuroplasticity and upper limb motor function in patients with chronic stroke: a randomized controlled trial. BMC neurology, 22(1), 21.
27. Lasek-Bal A, Jędrzejowska-Szypułka H, Różycka J, Bal W, Holecki M, Duława J, et al. Low concentration of BDNF in the acute phase of ischemic stroke as a factor in poor prognosis in terms of functional status of patients. Med Sci Monit. 2015; 21:3900–3905.
28. Wang J, Gao L, Yang YL, Li YQ, Chang T, Man MH, et al. Low serum levels of brain-derived neurotrophic factor were associated with poor short-term functional outcome and mortality in acute ischemic stroke. Mol Neurobiol. 2017; 54:7335–7342.
29. Astuti A, Sutarni S, Setyopranoto I. Serum brain-derived neurotrophic factor (BDNF) level may predict the functional outcome of acute ischemic stroke patients. Biomed Pharmacol J. 2020; 13:1963–1973.
30. Sobrino T, Rodríguez-Yáñez M, Campos F, Iglesias-Rey R, Millán M, de la Ossa NP, et al. Association of high serum levels of growth factors with good outcome in ischemic stroke: a multicenter study. Transl Stroke Res. 2020; 11:653–663.
31. Stanne TM, Åberg ND, Nilsson S, Jood K, Blomstrand C, Andreasson U, et al. Low circulating acute brain-derived neurotrophic factor levels are associated with poor long-term functional outcome after ischemic stroke. Stroke. 2016; 47:1943–1945.
32. Keci A, Tani K, Xhema J. Role of rehabilitation in neural plasticity. Open Access Macedonian J Med Sci. 2019;7(9):1540.
33. Lee KE, Choi M, Jeoung B. Effectiveness of Rehabilitation Exercise in improving physical function of Stroke patients: a systematic review. Int J Environ Res Public Health. 2022; 19:19.
34. Iosa, M., Morone, G., Fusco, A., Castagnoli, M., Fusco, F. R., Pratesi, L., & Paolucci, S. (2015). Leap motion controlled videogame-based therapy for rehabilitation of elderly patients with subacute stroke: a feasibility pilot study. Topics in stroke rehabilitation, 22(4), 306–316.
35. Smeragliuolo, A. H., Hill, N. J., Disla, L., & Putrino, D. (2016). Validation of the Leap Motion Controller using markered motion capture technology. Journal of biomechanics, 49(9), 1742–1750.
36. Mojtabavi H, Shaka Z, Momtazmanesh S, Ajdari A, Rezaei N. Circulating brain-derived neurotrophic factor as a potential biomarker in stroke: a systematic review and meta-analysis. J Transl Med. 2022 Mar 14;20(1):126.
37. Petrova LV, Kostenko EV, Martynov MY, Pogonchenkova IV, Kopasheva VD. Vliyanie reabilitatsii s sensornoi perchatkoi i virtual'noi real'nost'yu na dinamiku neirotroficheskogo faktora golovnogo mozga i kognitivnykh vyzvannykh potentsialov P300 v rannem vosstanovitel'nom periode ishemicheskogo insul'ta [The effect of rehabilitation with sensory glove and virtual reality on concentration of brain-derived neurotrophic factor and event related potential P300 in the early rehabilitation period after ischemic stroke]. Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(12. Vyp. 2):75-81.
38. Koroleva ES, Tolmachev IV, Alifirova VM, Boiko AS, Levchuk LA, Loonen AJM, Ivanova SA. Serum BDNF's Role as a Biomarker for Motor Training in the Context of AR-Based Rehabilitation after Ischemic Stroke. Brain Sci. 2020 Sep 9;10(9):623.
39. Lee HS, Lim JH, Jeon BH, Song CS. Non-immersive Virtual Reality Rehabilitation Applied to a Task-oriented Approach for Stroke Patients: A Randomized Controlled Trial. Restor Neurol Neurosci. 2020;38(2):165-172.
40. Yang SW, Ma SR, Choi JB. The Effect of Kinesio Taping Combined with Virtual-Reality-Based Upper Extremity Training on Upper Extremity Function and Self-Esteem in Stroke Patients. Healthcare (Basel). 2023 Jun 21;11(13):1813.
41. Zhang N, Wang H, Wang H, Qie S. Impact of the combination of virtual reality and noninvasive brain stimulation on the upper limb motor function of stroke patients: a systematic review and meta-analysis. J Neuroeng Rehabil. 2024 Oct 5;21(1):179.
42. Patel J, Fluet G, Qiu Q, Yarossi M, Merians A, Tunik E, Adamovich S. Intensive virtual reality and robotic based upper limb training compared to usual care, and associated cortical reorganization, in the acute and early sub-acute periods post-stroke: a feasibility study. J Neuroeng Rehabil. 2019 Jul 17;16(1):92.
43. Shen J, Gu X, Fu J, Yao Y, Li Y, Zeng M, Liu Z, Lu C. Virtual reality-induced motor function of the upper extremity and brain activation in stroke: study protocol for a randomized controlled trial. Front Neurol. 2023 Apr 17;14:1094617.
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Affiliations
Mariel Daba
Universitas Medika Suherman
Nathasya Ferdyastari
Universitas Medika Suherman
Luh Ade Lela
Universitas Medika Suherman
How to Cite
1.
Daba M, Ferdyastari N, Lela L. Pengaruh Latihan Motorik Berbasis Virtual Reality Terhadap Aktivitas Serum Brain-Derived Neurotrophic Factor (BDNF) Pada Pasien Dengan Kondisi Stroke [Internet]. Jurnal Kesehatan Terpadu (Integrated Health Journal) [Internet]. 5Jan.2026 [cited 28Feb.2026];16(2):95-105. Available from: https://www.jurnalpoltekkesmaluku.com/index.php/JKT/article/view/713
Pengaruh Latihan Motorik Berbasis Virtual Reality Terhadap Aktivitas Serum Brain-Derived Neurotrophic Factor (BDNF) Pada Pasien Dengan Kondisi Stroke
Vol 16 No 2 (2025): Jurnal Kesehatan Terpadu (Integrated Health Journal)
Submitted: Sep 14, 2025
Published: Jan 5, 2026
Abstract
Stroke remains a leading cause of disability worldwide, and rehabilitation strategies that enhance neuroplasticity are essential for functional recovery. VR has emerged as an innovative approach to motor control training, providing multisensory stimulation and increasing patient engagement. This study aimed to evaluate the effect of VR-based motor control training on serum BDNF levels and upper extremity motor function in stroke patients. A quasi-experimental two-group pretest–posttest design was conducted with 30 stroke patients recruited through purposive sampling, divided equally into VR and control groups. The VR intervention, delivered using Oculus Quest 2, consisted of four sessions (10–20 minutes/session, 2–3 times per week) incorporating modules for bilateral coordination, reaching, gripping, balance, and cognitive–motor dual tasks. Motor function was assessed using the WMFT, and serum BDNF levels were measured pre- and post-intervention using ELISA. Results showed that BDNF levels in the control group remained unchanged (1.24 ng/mL), while the VR group demonstrated a significant increase from 1.45 to 1.54 ng/mL (p < 0.0001). WMFT scores improved in both groups, but the improvement was greater in the VR group (38 ± 0.39 to 42 ± 0.39; p < 0.0001). These findings indicate that VR-based motor training effectively enhances serum BDNF levels and motor function in stroke patients. Further studies with larger samples, more intensive interventions, and long-term follow-up are recommended.
Keywords: Virtual Reality, BDNF, Neuroplastisitas, Motor Function, Stroke