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      Effects of Training Using Video Games on the Muscle Strength, Muscle Tone, and Activities of Daily Living of Chronic Stroke Patients

      research-article
      , PT, PhD 1
      Journal of Physical Therapy Science
      The Society of Physical Therapy Science
      Video game, Stroke, Motor function

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          Abstract

          [Purpose] The purpose of this study was to investigate the effects of training using video games played on the Xbox Kinect on the muscle strength, muscle tone, and activities of daily living of post-stroke patients. [Subjects] Fourteen stroke patients were recruited. They were randomly allocated into two groups; the experimental group (n=7) and the control group (n=7). [Methods] The experimental group performed training using video games played on the Xbox Kinect together with conventional occupational therapy for 6 weeks (1 hour/day, 3 days/week), and the control group received conventional occupational therapy only for 6 weeks (30 min/day, 3 days/week). Before and after the intervention, the participants were measured for muscle strength, muscle tone, and performance of activities of daily living. [Results] There were significant differences pre- and post-test in muscle strength of the upper extremities, except the wrist, and performance of activities of daily living in the experimental group. There were no significant differences between the two groups at post-test. [Conclusion] The training using video games played on the Xbox Kinect had a positive effect on the motor function and performance of activities of daily living. This study showed that training using video games played on the Xbox Kinect may be an effective intervention for the rehabilitation of stroke patients.

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          Most cited references11

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          Virtual reality in stroke rehabilitation: a meta-analysis and implications for clinicians.

          Approximately two thirds of stroke survivors continue to experience motor deficits of the arm resulting in diminished quality of life. Conventional rehabilitation provides modest and sometimes delayed effects. Virtual reality (VR) technology is a novel adjunctive therapy that could be applied in neurorehabilitation. We performed a meta-analysis to determine the added benefit of VR technology on arm motor recovery after stroke. We searched Medline, EMBASE, and Cochrane literature from 1966 to July 2010 with the terms "stroke," "virtual reality," and "upper arm/extremity." We evaluated the effect of VR on motor function improvement after stroke. From the 35 studies identified, 12 met the inclusion/exclusion criteria totaling 195 participants. Among them, there were 5 randomized clinical trials and 7 observational studies with a pre-/postintervention design. Interventions were delivered within 4 to 6 weeks in 9 of the studies and within 2 to 3 weeks in the remaining 3. Eleven of 12 studies showed a significant benefit toward VR for the selected outcomes. In the pooled analysis of all 5 randomized controlled trials, the effect of VR on motor impairment (Fugl-Meyer) was OR=4.89 (95% CI, 1.31 to 18.3). No significant difference was observed for Box and Block Test or motor function. Among observational studies, there was a 14.7% (95% CI, 8.7%-23.6%) improvement in motor impairment and a 20.1% (95% CI, 11.0%-33.8%) improvement in motor function after VR. VR and video game applications are novel and potentially useful technologies that can be combined with conventional rehabilitation for upper arm improvement after stroke.
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            Use of a low-cost, commercially available gaming console (Wii) for rehabilitation of an adolescent with cerebral palsy.

            The purpose of this retrospective and prospective case report is to describe the feasibility and outcomes of using a low-cost, commercially available gaming system (Wii) to augment the rehabilitation of an adolescent with cerebral palsy. The patient was an adolescent with spastic diplegic cerebral palsy classified as GMFCS level III who was treated during a summer session in a school-based setting. The patient participated in 11 training sessions, 2 of which included other players. Sessions were between 60 and 90 minutes in duration. Training was performed using the Wii sports games software, including boxing, tennis, bowling, and golf. He trained in both standing and sitting positions. Three main outcome measures were used: (1) visual-perceptual processing, using a motor-free perceptual test (Test of Visual Perceptual Skills, third edition); (2) postural control, using weight distribution and sway measures; and (3) functional mobility, using gait distance. Improvements in visual-perceptual processing, postural control, and functional mobility were measured after training. The feasibility of using the system in the school-based setting during the summer session was supported. For this patient whose rehabilitation was augmented with the Wii, there were positive outcomes at the impairment and functional levels. Multiple hypotheses were proposed for the findings that may be the springboard for additional research. To the authors' knowledge, this is the first published report on using this particular low-cost, commercially available gaming technology for rehabilitation of a person with cerebral palsy.
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              A feasibility study using interactive commercial off-the-shelf computer gaming in upper limb rehabilitation in patients after stroke.

              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. 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. 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. 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. 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.
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                Author and article information

                Journal
                J Phys Ther Sci
                J Phys Ther Sci
                JPTS
                Journal of Physical Therapy Science
                The Society of Physical Therapy Science
                0915-5287
                2187-5626
                29 June 2013
                May 2013
                : 25
                : 5
                : 595-597
                Affiliations
                [1) ] Department of Physical Therapy, College of Natural Science, Kyungnam University
                Author notes
                Mailing address: GyuChang Lee, Department of Physical Therapy, College of Natural Science, Kyungnam University: 7 Kyungnamdaehak-ro, Masanhappo-gu, Changwon-si, Gyeongsangnam-do 631-701, Republic of Korea. TEL: +82 55-249-2739, FAX: +82 505-999-2173 E-mail: leegc76@ 123456kyungnam.ac.kr
                Article
                jpts-2012-396
                10.1589/jpts.25.595
                3804992
                24259810
                e300b872-30ac-493d-826e-8e48f14da4c4
                by the Society of Physical Therapy Science

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License.

                History
                : 09 November 2012
                : 09 January 2013
                Categories
                Original

                video game,stroke,motor function
                video game, stroke, motor function

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