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Clinical feasibility of interactive motion-controlled games for stroke rehabilitation.

Bower KJ, Louie J, Landesrocha Y, Seedy P, Gorelik A, Bernhardt J - J Neuroeng Rehabil (2015)

Bottom Line: There were no serious adverse safety events reported in either phase of the study; however, a number of participants reported minor increases in pain.A post-stroke intervention using interactive motion-controlled games shows promise as a feasible and potentially effective treatment approach.This paper presents important recommendations for future game development and research to further explore long-term adherence, acceptability, safety and efficacy.

View Article: PubMed Central - PubMed

Affiliation: Department of Physiotherapy, Royal Melbourne Hospital, Melbourne, VIC, Australia. kelly.bower@acu.edu.au.

ABSTRACT

Background: Active gaming technologies, including the Nintendo Wii and Xbox Kinect, have become increasingly popular for use in stroke rehabilitation. However, these systems are not specifically designed for this purpose and have limitations. The aim of this study was to investigate the feasibility of using a suite of motion-controlled games in individuals with stroke undergoing rehabilitation.

Methods: Four games, which utilised a depth-sensing camera (PrimeSense), were developed and tested. The games could be played in a seated or standing position. Three games were controlled by movement of the torso and one by upper limb movement. Phase 1 involved consecutive recruitment of 40 individuals with stroke who were able to sit unsupported. Participants were randomly assigned to trial one game during a single session. Sixteen individuals from Phase 1 were recruited to Phase 2. These participants were randomly assigned to an intervention or control group. Intervention participants performed an additional eight sessions over four weeks using all four game activities. Feasibility was assessed by examining recruitment, adherence, acceptability and safety in both phases of the study.

Results: Forty individuals (mean age 63 years) completed Phase 1, with an average session time of 34 min. The majority of Phase 1 participants reported the session to be enjoyable (93 %), helpful (80 %) and something they would like to include in their therapy (88 %). Sixteen individuals (mean age 61 years) took part in Phase 2, with an average of seven 26-min sessions over four weeks. Reported acceptability was high for the intervention group and improvements over time were seen in several functional outcome measures. There were no serious adverse safety events reported in either phase of the study; however, a number of participants reported minor increases in pain.

Conclusions: A post-stroke intervention using interactive motion-controlled games shows promise as a feasible and potentially effective treatment approach. This paper presents important recommendations for future game development and research to further explore long-term adherence, acceptability, safety and efficacy.

Trial registration: Australian and New Zealand Clinical Trials Registry ( ACTRN12613000220763 ).

No MeSH data available.


Related in: MedlinePlus

Study flow diagram
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Fig2: Study flow diagram

Mentions: Phase 1: Forty of 89 individuals screened agreed to take part in Phase 1 of the study; 42 were ineligible and seven declined consent (Fig. 2). As people with stroke from slow-stream rehabilitation wards were also screened, the primary reasons for exclusion were due to significant cognitive or physical deficits (i.e. unable to sit unsupported or adequately follow instructions). Phase 1 participants were a mean age of 63.1 years, with a median time since stroke of 5.5 weeks (Table 1). Mini-Mental State Examination scores ranged from 20 to 30 and Motor Assessment Scale scores ranged from 9 to 48. No significant differences between the four groups within Phase 1 were observed.Fig. 2


Clinical feasibility of interactive motion-controlled games for stroke rehabilitation.

Bower KJ, Louie J, Landesrocha Y, Seedy P, Gorelik A, Bernhardt J - J Neuroeng Rehabil (2015)

Study flow diagram
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4522120&req=5

Fig2: Study flow diagram
Mentions: Phase 1: Forty of 89 individuals screened agreed to take part in Phase 1 of the study; 42 were ineligible and seven declined consent (Fig. 2). As people with stroke from slow-stream rehabilitation wards were also screened, the primary reasons for exclusion were due to significant cognitive or physical deficits (i.e. unable to sit unsupported or adequately follow instructions). Phase 1 participants were a mean age of 63.1 years, with a median time since stroke of 5.5 weeks (Table 1). Mini-Mental State Examination scores ranged from 20 to 30 and Motor Assessment Scale scores ranged from 9 to 48. No significant differences between the four groups within Phase 1 were observed.Fig. 2

Bottom Line: There were no serious adverse safety events reported in either phase of the study; however, a number of participants reported minor increases in pain.A post-stroke intervention using interactive motion-controlled games shows promise as a feasible and potentially effective treatment approach.This paper presents important recommendations for future game development and research to further explore long-term adherence, acceptability, safety and efficacy.

View Article: PubMed Central - PubMed

Affiliation: Department of Physiotherapy, Royal Melbourne Hospital, Melbourne, VIC, Australia. kelly.bower@acu.edu.au.

ABSTRACT

Background: Active gaming technologies, including the Nintendo Wii and Xbox Kinect, have become increasingly popular for use in stroke rehabilitation. However, these systems are not specifically designed for this purpose and have limitations. The aim of this study was to investigate the feasibility of using a suite of motion-controlled games in individuals with stroke undergoing rehabilitation.

Methods: Four games, which utilised a depth-sensing camera (PrimeSense), were developed and tested. The games could be played in a seated or standing position. Three games were controlled by movement of the torso and one by upper limb movement. Phase 1 involved consecutive recruitment of 40 individuals with stroke who were able to sit unsupported. Participants were randomly assigned to trial one game during a single session. Sixteen individuals from Phase 1 were recruited to Phase 2. These participants were randomly assigned to an intervention or control group. Intervention participants performed an additional eight sessions over four weeks using all four game activities. Feasibility was assessed by examining recruitment, adherence, acceptability and safety in both phases of the study.

Results: Forty individuals (mean age 63 years) completed Phase 1, with an average session time of 34 min. The majority of Phase 1 participants reported the session to be enjoyable (93 %), helpful (80 %) and something they would like to include in their therapy (88 %). Sixteen individuals (mean age 61 years) took part in Phase 2, with an average of seven 26-min sessions over four weeks. Reported acceptability was high for the intervention group and improvements over time were seen in several functional outcome measures. There were no serious adverse safety events reported in either phase of the study; however, a number of participants reported minor increases in pain.

Conclusions: A post-stroke intervention using interactive motion-controlled games shows promise as a feasible and potentially effective treatment approach. This paper presents important recommendations for future game development and research to further explore long-term adherence, acceptability, safety and efficacy.

Trial registration: Australian and New Zealand Clinical Trials Registry ( ACTRN12613000220763 ).

No MeSH data available.


Related in: MedlinePlus