Stroke is the most common neurological disease in the world. After the stroke, some people suffer a cognitive disability. Commercial videogames have been used after stroke for physical rehabilitation; however, their use in cognitive rehabilitation has hardly been studied. The objectives of this study were to analyze attention, processing speed, and working memory in patients with moderate stroke after an intervention with Wii Sports Resort and compared these results with a control group.
A pre-post design study was conducted with 30 moderate stroke patients aged 65 ± 15. The study lasted eight weeks. 15 participated in the intervention group and 15 belong to the control group. They were assessed in attention and processing speed (TMT-A and B) and working memory (Digit Span of WAIS-III). Parametric and effect size tests were used to analyze the improvement of those outcomes and compared both groups.
At the baseline, there was no difference between TMT-A and B. A difference was found in the scalar score of TMT-B, as well as in Digit Backward Span and Total Digit Task. In TMT-A and B, the intervention group had better scores than the control group. The intervention group in the Digit Forward Span and the Total Digit obtained a moderate effect size and the control group also obtained a moderate effect size in Total Digit. In the Digit scalar scores, the control group achieved better results than the intervention group.
The results on attention, processing speed and working memory improved in both groups. However, according to the effect sizes, the intervention group achieved better results than the control group. In addition, the attention and processing speed improved more than the working memory after the intervention. Although more studies are needed in this area, the results are encouraging for cognitive rehabilitation after stroke.
Stroke is a really common neurological circulatory disorder, around 795,000 people suffer a new stroke every year and 185,000 are recurrent cases . It is the second most common cause of dementia, death and more than 32% people after stroke suffer from cognitive impairments , and the third most common cause of disability which in five years after stroke the disabilities levels increase from 14 to 23% . The after-effects of suffering a stroke can appear on a physical level, such as motor disorders [3, 4], hemiparesis , dizziness, vertigo and various sight and speech problems . There can also be cognitive side-effects [7, 8], such as cognitive impairment [9, 10] and various attention disorders  on a spatial cognition  and behavioral  level.
Various studies have been conducted to improve the physical after-effects and to analyze functional capacity through physical activity and motor skills [3, 14, 15], and evidence has been found to suggest that physical activity leads to changes in brain structure [16, 17]. On a physical level, rehabilitation exercises have also been designed to recover the mobility of the affected hands and upper limbs [4, 18], as well as botox (botulinum toxin type A) treatments to improve the spasticity of the affected upper limbs .
There has also been research on a psychological level  to analyze post-stroke depression [21, 22] and quality of life [2, 23]. To improve the effects on a cognitive level, rehabilitation studies have been conducted to reduce attention deficits , aphasia  and to work on cognition to improve functional activity [25, 26]. The cognitive after-effects have been studied in the fields of neuropsychology  and neurorehabilitation [28, 29]. In neuropsychology, two of the most widely used instruments to measure cognitive abilities such as attention, processing speed and working memory, among others, have been the Trail Making Test [30, 31] and the WAIS Digit Span task .
Meanwhile, to decrease the affect-effects of strokes, there have also been studies on the impact of physical activity using commercial videogames, and their use in rehabilitation to control mainly physical consequences [33, 34], such as balance and gait disorders [33, 35] and effects on the upper limbs [36, 37]. However, there is hardly any scientific evidence regarding the use of commercial videogames to do physical activity in order to recover cognition [38, 39]. Hence, the main goal of this study was to evaluate the effect on the cognitive areas of attention, processing speed and working memory in people that have suffered a moderate stroke following an intervention with the Nintendo Wii Sports Resort and compared to a control group who did not receive the intervention with the Nintendo Wii Sport Resort.[…]