Approximately 30% of stroke survivors experience an upper limb impairment, which impacts on participation and quality of life. Gaming devices (Nintendo Wii) are being incorporated into rehabilitation to improve function. We explored the stroke survivor experience of gaming as an upper limb intervention.
Semi-structured, individual interviews with stroke survivors living within the UK were completed. Interviews were audio-recorded, transcribed verbatim and analysed using Framework methods. Transcripts were coded and summarised into thematic charts. Thematic charts were refined during analysis until the final framework emerged.
We captured experiences of 12 stroke survivors who used Nintendo Wii. Gaming devices were found to be acceptable for all ages but varying levels of enthusiasm existed. Enthusiastic players described gaming as having a positive impact on their motivation to engage in rehabilitation. For some, this became a leisure activity, encouraging self-practice. Non-enthusiastic players preferred sports to gaming.
An in-depth account of stroke survivor experiences of gaming within upper limb rehabilitation has been captured. Suitability of gaming should be assessed individually and stroke survivor abilities and preference for interventions should be taken into consideration. There was no indication that older stroke survivors or those with no previous experience of gaming were less likely to enjoy the activity.
Stroke is considered to be a major cause of serious, long-term disability in Europe.1 Within the UK, hemiparesis affects up to 80% of the estimated 1.3 million stroke survivors2 and is persistent, with 30–66% still experiencing difficulties with arm movement or function 6 months after their stroke.3 Stroke upper limb impairment is a top research priority for stroke survivors and healthcare professionals.4 Intensive, repetitive and functional movements are considered most effective in promotion of recovery5 and commercial gaming devices (e.g. Nintendo Wii) encourage high repetition of arm movements.6 Some stroke rehabilitation services have introduced commercial gaming devices to address upper limb impairment.7 However, little information is available on the stroke survivor experience of this intervention.8 In order to be able to inform future research and aid health professionals in making clinical judgements about suitability of intervention, optimising adherence and facilitating implementation, it is important to capture the perspectives of stroke survivors.
Celinder and Peoples9 interviewed nine Danish stroke survivors who played Nintendo Wii within a pilot inpatient rehabilitation programme. The study focused on physical and cognitive rehabilitation and concluded that Nintendo Wii could be used to promote engagement in leisure activities. Wingham et al.10 interviewed 18 stroke survivors who used Nintendo Wii as part of a home-based upper limb rehabilitation programme. They reported high usage rates within the home and the intervention was found to be acceptable to both stroke survivors and caregivers. Limited information was however captured on factors that influence engagement in upper limb rehabilitation. In addition, Lewis et al.11 in their literature review (three articles including participants with chronic neurological conditions) concluded that use of virtual reality offered increased enjoyment and motivation compared to traditional rehabilitation. The aim of our qualitative study was to explore whether use of commercial gaming devices for upper limb rehabilitation was acceptable to stroke survivors and to capture their experience of this intervention. A pragmatic stance was taken to this study where investigations are not necessarily aligned to a particular qualitative research method.[…]