Virtual Reality Mirror Therapy With Focused Object-Directed Attention System

• task-oriented training (Other): Virtual Reality Mirror Therapy combined with Motor training targeted to goals that are relevant to the functional needs of the patient

Primary outcomes

• Change in the result of Fugl-Meyer assessment (FMA) for motor function of upper extremity test [baseline, 9 weeks and 21 weeks]: Each item is rated on a three-point ordinal scale (2 points for the detail being performed completely, 1 point for the detail being performed partially, and 0 for the detail not being performed). The maximum motor performance score is 66 points for the upper extremity.

Secondary outcomes

• Change in the result of Modified Ashworth scale (MAS) [baseline, 9 weeks and 21 weeks]: Muscle tone is defined by assess muscle tone by evaluating resistance to passive stretch, reflecting the level of spasticity, with scores ranging from 0 (no increase in tone) to 4 (rigidity in flexion or extension).
• Change in the result of Box and blocks test [baseline, 9 weeks and 21 weeks]: The score is the number of blocks carried from one box to the other in one minute. Higher values represent a better outcome.
• Change in the result of Semmes-Weinstein monofilament (SWM) test [baseline, 9 weeks and 21 weeks]: The Semmes-Weinstein monofilamenttest examines the cutaneous pressure threshold, range from 1.65-6.65. Higher values represent a worse outcome.
• Change in the result of Motor Activity Log [baseline, 9 weeks and 21 weeks]: Semi-structured interview examine how much and how well the subject uses their more-affected arm for 30 ADLs. Score range from 0-5. Higher values represent a better outcome.
• Surface electromyography (sEMG) [baseline, 9 weeks]: Change in the root mean square (RMS) of the EMG signal was computed to quantify the change of muscle activation.
• Clinical Global Impression (CGI) scale [9 weeks]: Assess overall clinical change, rated on a 7-point scale ranging from 1 (very much improved) to 7 (very much worse).

Sex: All, ages: 20 Years to 80 Years, accepts healthy volunteers

Inclusion Criteria:

* Clinical diagnosis of stroke with unilateral side involved;
* A score of Mini-mental state examination greater than 24 for proving higher mental function;
* Time of onset > 6 months before treatment begins;
* Premorbid right-handedness.

Exclusion Criteria:

* Severe vision impairment;
* Major cognitive-perceptual deficit;
* Other brain disease.