This study aimed to evaluate the effectiveness of interactive video games (IVGs) in rehabilitation motivation and walking and balance abilities in chronic stroke patients.
Materials and Methods:
In this dual-center controlled trial, 24 chronic stroke patients from rehabilitation centers A and B were randomly assigned to an experimental (IVGs + traditional neurodevelopment treatment [TNT], n = 12) or a control group (walking training + TNT, n = 12). The patients in both the groups underwent TNT for 4 weeks (5 days/week) before undergoing either IVGs or walking training (4 weeks, 3 days/week) depending on the group. The primary and secondary outcomes were rehabilitation motivation and the Berg Balance Scale (BBS) score, Functional Reach Test (FRT) performance, and walking speed (WS), respectively.
Results:
The patients in both the groups showed significant increase in the BBS score, FRT performance, and WS; however, the experimental group showed more significant improvements in rehabilitation motivation (P = 0.02, η2 = 0.415) and WS (P = 0.05, η2 = 0.333) than the patients in the control group.
Conclusion:
This study suggests that the IVGs in combination with TNT provide effective rehabilitation motivation in chronic stroke patients.
Clinical Trial Registration number: KCT0003408.
Get full access to this article
View all access options for this article.
References
1.
CalauttiC, BaronJC. Functional neuroimaging studies of motor recovery after stroke in adults: A review. Stroke, 2003; 34:1553–1566.
2.
WernerC, Von FrankenbergS, TreigT, et al.Treadmill training with partial body weight support and an electromechanical gait trainer for restoration of gait in subacute stroke patients: A randomized crossover study. Stroke, 2002; 33:2895–2901.
3.
ChangYJ, ChenSF, HuangJD. A Kinect-based system for physical rehabilitation: A pilot study for young adults with motor disabilities. Res Dev Disabil, 2011; 32:2566–2570.
4.
ColomboR, PisanoF, MazzoneA, et al.Design strategies to improve patient motivation during robot-aided rehabilitation. J Neuroeng Rehabil, 2007; 4:1–12.
5.
MacleanN, PoundP, WolfeC, RuddA. The concept of patient motivation: A qualitative analysis of stroke professionals' attitudes. Stroke, 2002; 33:444–448.
6.
MacleanN, PoundP, WolfeC, RuddA. Qualitative analysis of stroke patients' motivation for rehabilitation. BMJ, 2000; 321:1051–1054.
7.
MoroneG, TramontanoM, IosaM, et al.The efficacy of balance training with video game-based therapy in subacute stroke patients: A randomized controlled trial. Biomed Res Int, 2014; 2014:580861.
8.
Pintado-IzquierdoS, Cano-de-la-CuerdaR, Ortiz-GutiérrezRM. Video game-based therapy on balance and gait of patients with stroke: A systematic review. Appl Sci, 2020; 10:6426.
9.
Cano-MañasMJ, Collado-VázquezS, Rodríguez HernándezJ, et al.Effects of video-game based therapy on balance, postural control, functionality, and quality of life of patients with subacute stroke: A randomized controlled trial. J Healthc Eng, 2020; 2020:5480315.
10.
BurkeJW, McNeillMDJ, CharlesDK, et al.Optimising engagement for stroke rehabilitation using serious games. Vis Comput, 2009; 25:1085–1099.
11.
DeutschJE, BorbelyM, FillerJ, et al.Use of a low-cost, commercially available gaming console (Wii) for rehabilitation of an adolescent with cerebral palsy. Phys Ther, 2008; 88:1196–1207.
12.
AkinwuntanAE, De WeerdtW, FeysH, et al.Effect of simulator training on driving after stroke: A randomized controlled trial. Neurology, 2005; 65:843–850.
13.
LeeD, BaeY. The effectiveness of driving game on trunk control and gait ability in stroke. J Mot Behav, 2020; 52:33–40.
14.
CohenJ. Eta-squared and partial eta-squared in fixed factor ANOVA designs. Edu Psychol Meas, 1973; 33:107–112.
15.
BonnechèreB, JansenB, OmelinaL, Van Sint JanS. The use of commercial video games in rehabilitation: A systematic review. Int J Rehabil Res, 2016; 39:277–290.
16.
LeeMM, ShinDC, SongCH. Canoe game-based virtual reality training to improve trunk postural stability, balance, and upper limb motor function in subacute stroke patients: A randomized controlled pilot study. J Phys Ther Sci, 2016; 28:2019–2024.
17.
BetkerAL, SzturmT, MoussaviZK, NettC. Video game-based exercises for balance rehabilitation: A single-subject design. Arch Phys Med Rehabil, 2006; 87:1141–1149.
18.
BoddiceG, BrauerS, GustafssonL, et al.Stroke Foundation. Clinical Guidelines for Stroke Management. Melbourne: Stroke Foundation; 2010.
19.
WhiteGN, CordatoDJ, O'RourkeF, et al.Validation of the Stroke Rehabilitation Motivation Scale: A pilot study. Asian J Gerontol Geriatr, 2012; 7:80–87.
20.
ParkM, LeeJY, HamY, et al.Korean Version of the Stroke Rehabilitation Motivation Scale: Reliability and validity evaluation. Ann Rehabil Med, 2020; 44:11.
21.
BergK, WooddauphineeS, WilliamsJI. The balance scale-reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med, 1995; 27:27–36.
22.
AlghadirAH, Al-EisaES, AnwerS, SarkarB. Reliability, validity, and responsiveness of three scales for measuring balance in patients with chronic stroke. BMC Neurol, 2018; 18:141.
23.
DuncanPW, WeinerDK, ChandlerJ, StudenskiS. Functional reach: A new clinical measure of balance. J Gerontol, 1990; 45:M192–M197.
24.
FulkGD, EchternachJL. Test-retest reliability and minimal detectable change of gait speed in individuals undergoing rehabilitation after stroke. J Neurol Phys Ther, 2008; 32:8–13.
25.
KhanittanuphongP, TipchatyotinS. Correlation of the gait speed with the quality of life and the quality of life classified according to speed-based community ambulation in Thai stroke survivors. NeuroRehabilitation, 2017; 41:135–141.
26.
FritzCO, MorrisPE, RichlerJJ. Effect size estimates: Current use, calculations, and interpretation. J Exp Psychol Gen, 2012; 141:2–18.
27.
BakemanR. Recommended effect size statistics for repeated measures designs. Behav Res Methods, 2005; 37:379–384.
28.
YelnikAP, Le BretonF, ColleFM, et al.Rehabilitation of balance after stroke with multisensorial training: A single-blind randomized controlled study. Neurorehabil Neural Repair, 2008; 22:468–476.
29.
Bonini-RochaAC, de AndradeALS, MoraesAM, et al.Effectiveness of circuit-based exercises on gait speed, balance, and functional mobility in people affected by stroke: A meta-analysis. PM&R, 2018; 10:398–409.
30.
FrenchB, ThomasLH, CoupeJ, et al.Repetitive task training for improving functional ability after stroke. Cochrane Database Syst Rev, 2016; 11.
31.
PyaeA, LuimulaM, SmedJ. Understanding stroke patients' motivation for motivation-driven rehabilitative game design. Internet of Things, User-Centric IoT, 2015; 99–111.
32.
HungYX, HuangPC, ChenKT, ChuWC. What do stroke patients look for in game-based rehabilitation: A survey study. Medicine (Baltimore), 2016; 95:e3032.
33.
LaverKE, LangeB, GeorgeS, et al.Virtual reality for stroke rehabilitation. Cochrane Database Syst Rev, 2017; 11:CD008349.
34.
LeeHS, ParkYJ, ParkSW. The effects of virtual reality training on function in chronic stroke patients: A systematic review and meta-analysis. BioMed Res Int, 2019; 2019:7595639.
35.
CorbettaD, ImeriF, GattiR. Rehabilitation that incorporates virtual reality is more effective than standard rehabilitation for improving walking speed, balance and mobility after stroke: A systematic review. J Physiother, 2015; 61:117–124.
36.
DiasP, SilvaR, AmorimP, et al.Using virtual reality to increase motivation in poststroke rehabilitation. IEEE Comput Graph Appl, 2019; 39:64–70.
37.
WonJI. Impact of patients' level of participation in rehabilitation on functional outcome in patients with stroke. Phys Ther Kor, 2020; 27:63–69.
38.
YangYR, TsaiMP, ChuangTY, et al.Virtual reality-based training improves community ambulation in individuals with stroke: A randomized controlled trial. Gait Posture, 2008; 28:201–206.
39.
KimJO, LeeBH. Effect of upper extremity coordination exercise during standing on the paretic side on balance, gait ability and activities of daily living in persons with stroke. Phys Ther Rehabil Sci, 2017; 6:53–58.
