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Objective: This research aims to develop evidence-based therapy protocols along with an innovative virtual reality (VR) motor training system for upper extremity (UE) rehabilitation in adults with chronic hemiparesis.This study intended to construct an integrated assessment method with the analysis of multi-dimension data from electrocardiography, etectromyography, kinematics, kinetics and task performance.Further, the study examined the feasibility and effectiveness of the proposed system and investigated a social-psychological behavior model from patients perspective in order to find correlations between performance improvement and human perceptions or emotion status.Relevance: Upper extremity (UE) motor impairment is a common consequence of stroke and often produces significant challenges for patients as they engage in everyday instrumental activities of daily living.Evidence suggests that intense, focused task-specific training is efficacious for promoting recovery after centrally-induced paresis.Virtual reality (VR) enhanced motor training is an emerging therapeutic modality that can serve to deliver UE motor training tasks within consistent, yet modifiable simulated functional environments that mimic real world challenges.Methods: A series of VR tasks were developed to serve UE motor skills which included pinch, wrist flexion/extension, forearm pronation/supination and shoulder-arm exercise, while VR systems were built with innovative technologies including motion tracking, stereoscopics, haptics and video games.A clinical experiment is now conducting at Taipei Veteran Hospital, Taiwan and plan to recruit 30 participants with each going via twelve therapy sessions (2 hrs per session).Traditional clinical assessments: Wolf Motor Function Test, Fugl-Meyer Assessment of Physical Performance, Motor Activity Log, Box and Block Test of Manual Dexterity and Action Research Arm Test, are applied at pre stage and post stage.Besides, several motor patterns are selected as standard actions to collect data from electrocardiography and electromyography devices at pre stage and post stage as well.Also, questionnaires: Mood, Ease of Use, Usefulness, Willingness to Use and Presence, are designed to measure human perceptions and emotion status after the therapy.A pilot test with 4 participants has been conducted and the rest of the experiment is undergoing.Results: The case study was made from pilot test and results showed significant improvements in both Wolf Motor Function Test and Fugl-Meyer Assessment.Several motor indexes: stability, efficiency, speed and discontinuity were successfully extracted from kinematic data with which progressions were revealed along with the time history.Also, scores were ranging from 3.9 to 4.6 (total 5) in questionnaires of Ease of Use, Usefulness, Willingness to Use and Presence.More complete data set and results (30 participants) will be presented during the conference.Conclusion: Our findings demonstrate that a new VR system was both feasible and efficacious for use in upper extremity rehabilitation of adults with centrally-induced hemiparesis.Also, improvements were found from both clinical assessment and derived motor indexes.Individualized systematic practice in a game-like environment optimized trial presentation for task progression that transferred to real world tasks.Future work will focus on the development of an algorithm for optimal task progression, optimization of system interface, development of a task library, and implementation of a more cost-effective design.