[Abstract] Impact of virtual reality game therapy and task-specific neurodevelopmental treatment on motor recovery in survivors of stroke

Abstract

Background/Aims

This study aimed to compare the impact of virtual reality game therapy and task-specific neurodevelopmental training on the motor recovery of upper limb and trunk control, as well as physical function, in people who have had a stroke.

Methods

This randomised, assessor-blinded clinical trial was conducted with 34 patients with post-stroke duration of 135 ± 23 days. Patients with first-onset cortical stroke aged 40–60 years, Mini-Mental State Examination score >20, ability to complete a nine-hole peg test within 120 seconds, ability to lift the affected arm at shoulder level and independent standing were included. Patients were excluded if they had unilateral neglect and musculoskeletal injuries of the affected limb in the past 2 months. Outcome measures used were the Fugl-Meyer Upper Extremity Scale, Action Research Arm Test, Trunk Impairment Scale and Stroke Impact Scale-16. The virtual reality game therapy group performed interactive table tennis, boxing and discus throwing games. The neurodevelopmental treatment group underwent task-specific movements of the upper limb in sitting and standing. All patients performed 45 minutes of treatment, 5 days a week for 4 weeks.

Results

Both groups showed improvements in all measures after training (P<0.05). There was a between-group difference of 3.47 points in Fugl-Meyer Upper Extremity Scale in favour of the virtual reality game therapy.

Conclusions

Both treatment regimens resulted in equal improvements in hand dexterity and trunk control after stroke. Virtual reality game therapy improved the upper limb motor recovery of stroke survivors to a greater extent than neurodevelopmental treatment.

Source: https://www.magonlinelibrary.com/doi/abs/10.12968/ijtr.2019.0070

[ARTICLE] Exergaming and rehabilitation: A methodology for the design of effective and safe therapeutic exergames

Abstract

We present here a comprehensive definition of therapeutic exergames from which a methodology to create safe exergames for real therapy pathways is derived. Three main steps are identified.

1. A clear identification of all the exercise requirements, not only in terms of goals of the therapy, but also in terms of additional constraints. Characteristic parameters for determining the challenge level and to assess progression are also defined in this phase.
2. The exercise is transformed into a Virtual Exercise, in which all the exercise elements are implemented inside a simple virtual environment. In this step the discussion between clinical and ICT teams allows maximizing the effectiveness of exergames implementation.
3. The final exergame is realized by introducing on top of the exercise all the game elements suggested by good game design to maximize entertainment.

A clear line between exercises and games is drawn here. We illustrate the methodology with exergames designed for

1. balance and posture and
2. neglect rehabilitation, implemented and tested with post-stroke patients training autonomously at home.

The methodology can have a broader impact as it can be applied also in other gaming fields in which the requirements go beyond entertainment.

Source: Exergaming and rehabilitation: A methodology for the design of effective and safe therapeutic exergames