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A feasibility study using interactive commercial off-the-shelf computer gaming in upper limb rehabilitation in patients after stroke
BACKGROUND: Commercial off-the-shelf computer gaming devices have been making inroads into the rehabilitation arena, with the objective of making therapeutic exercise fun and contextual. One such device is the Nintendo Wii. Published clinical studies evaluating its acceptance, potential benefits and side-effects in the rehabilitation of patients with post-stroke weakness are few in number.
OBJECTIVE: The aim of this study is to assess the feasibility of using the Nintendo Wii as an adjunct to conventional rehabilitation of patients with post-stroke upper limb weakness.
METHODS: Twenty rehabilitation inpatients within 3 months after a stroke with upper limb weakness received 6 sessions of upper limb exercises via a Nintendo Wii over 2 weeks in addition to conventional rehabilitation. Outcome measures include a questionnaire, Fugl-Meyer Assessment of Upper Limb Motor Function and visual analogue scale of upper limb pain.
RESULTS: A total of 16 subjects completed the study. All 16 found Nintendo Wii gaming enjoyable and comparable to, if not better than, conventional therapy. There were small but statistically significant improvements in the Fugl-Meyer Assessment and Motricity Index scores.
CONCLUSION: Nintendo Wii appears to be a feasible adjunctive device to augment conventional therapy in a cohort of subacute stroke patients with moderate impairments of upper limb strength and function.
Loh Yong Joo, Tjan Soon Yin, Donald Xu, Ernest Thia, Chia Pei Fen, Christopher Wee Keong Kuah, Keng-He Kong
- Widman LM, McDonald CM, Abresch RT. Effectiveness of an upper extremity exercise device integrated with computer gaming for aerobic training in adolescents with spinal cord dysfunction. J Spinal Cord Med 2006; 29: 363–370.
- Merians AS, Poizner H, Boian R, Burdea G, Adamovich S. Sensorimotor training in a virtual reality environment: does it improve functional recovery post stroke? Neurorehabil Neural Repair 2006; 20: 252–227.
- Crosbie JH, Lennon S, Basford JR, McDonough SM. Virtual reality in stroke rehabilitation: still more virtual than real. Disabil Rehabil 2007; 29: 1139–1146.
- Broeren J, Claesson L, Goude D, Rydmark M, Sunnerhagen KS. Virtual rehabilitation in an activity centre for community-dwelling persons with stroke. The possibilities of 3-dimensional computer games. Cerebrovasc Dis 2008; 26: 289–296.
- Johnson MJ, Ramachandran B, Paranjape RP, Kosasih JB. Feasibility study of TheraDrive: a low-cost game-based environment for the delivery of upper arm stroke therapy. Conf Proc IEEE Eng Med Biol Soc 2006; 1: 695–698.
- Kwakkel G, Kollen BJ, Wagenaar RC. Therapy impact on functional recovery in stroke rehabilitation. Physiotherapy 1995; 85: 377–391.
- Aziproz J, Barrios FA, Carrillo M, Carrillo R, Cerrato A, Hernandez J, et al. Game motivated and constraint induced therapy in late stroke with fMRI studies pre and post therapy. Proceedings of the 2005 IEEE, Digital Library, Engineering in Medicine and Biology 27th Annual Conference in Shanghai, China. 2005, p. 3695–3698.
- Deutsch JE, Borbely M, Filler J, Huhn K, Guarrera-Bowlby P. Use of a low-cost, commercially available gaming console (Wii) for rehabilitation of an adolescent with cerebral palsy. Phys Ther 2008; 88: 1196–1207.
- Yavuzer G, Senel A, Atay MB, Stam HJ. “Playstation EyeToy games” improve upper extremity-related motor functioning in subacute stroke: a randomized controlled clinical trial. Eur J Phys Rehabil Med 2008; 44: 237–244.
- Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient: a method for evaluation of physical performance. Scand J Rehabil Med 1975; 7: 13–31.
- Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther 1987; 67: 206–207.
- Hinojosa J, Kramer P. Statement – fundamental concepts of occupational therapy: occupation, purposeful activity, and function. Am J Occup Ther 1997; 51: 864–866.
- Ma H, Trombly CA. A systhesis of the effects of occupational therapy for persons with stroke, Part II: remediation of impairments. Am J Occup Ther 2002; 56: 260–274.
- Leder RS, Murillo N, Ibarra CP, Gushiken HC, Anaya GM, Escalana CO, et al. Engineering in Medicine and Biology Society, Proceedings of the 23rd Annual International Conference of the IEEE, Digital Library. Piscataway, USA: IEEE; 2001; 2: 1388–1390.
- Flynn S, Palma P, Bender A. Feasibility of using the Sony PlayStation 2 gaming platform for an individual poststroke: a case report. J Neurol Phys Ther; 2007; 31: 180–187.
- Amarshi F, Artero L, Reid D. Exploring social and leisure participation among stroke survivors: part two. Int J Ther Rehabil; 2006; 13: 199–208.
- Cowley AD, Minnaar G. New generation computer games: watch out for Wii shoulder. BMJ 2008; 336: 110.
- Warren J. A Wii workout: when videogames hurt. Wall Street Journal 2006-11-25. [cited 2006 Nov 25] Available from: http://online.wsj.com/public/article/SB116441076273232312-3nPirhZn20_L2P7m_ROtFUkh6yA_20071124.html]
- Bonis J. Acute Wiiinitis. N Engl J Med 2007; 356: 2431–2432.
- Hakala PT, Rimpela AH, Saarni LA, Salminen JJ. Frequent computer-related activities increase the risk of neck-shoulder and low back pain in adolescents. Eur J Public Health 2006; 16: 536–541.
- Harding GF, Harding PF. Photosensitive epilepsy and image safety. Appl Ergon 2008; Oct 16 [Epub ahead of print].
- Shoja MM, Tubbs RS, Malekian A, Jafari Rouhi AH, Barzgar M, Oakes WJ. Video game epilepsy in the twentieth century: a review. Childs Nerv Syst 2007; 23: 265–267.
- Ishiguro Y, Takada H, Watanabe K, Okumura A, Aso K, Ishikawa T. A follow-up survey on seizures induced by animated cartoon TV program “Pocket Monster”. Epilepsia 2004; 45: 377–383.
- Kasteleijn-Nolst Trenité DG, da Silva AM, Ricci S, Binnie CD, Rubboli G, Tassinari CA, et al. Video-game epilepsy: a European study. Epilepsia 1999; 40 Suppl 4: 70–74.
- Burn J, Dennis M, Bamford J, Sandercock P, Wade D, Warlow C. Epileptic seizures after a first stroke: the Oxfordshire Community Stroke Project. BMJ 1997; 315: 1582–1587.
- Wade DT, Langton Hewer RL, Wood VA, Skilbeck CE, Ismail HM. The hemiplegic arm after stroke: measurement and recovery. J Neurol Neurosurg Psychiatry 1983; 46: 521–524.
- Kwakkel G, Kollen BJ, van der Grond J, Prevo AJH. Probability of regaining dexterity in the flaccid upper limb – impact of severity of paresis and time since onset in acute stroke. Stroke 2003; 34: 2181–2186.
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