Effects of a repetitive gaming intervention on upper extremity impairments and function in persons with chronic stroke: a preliminary study.
OBJECTIVE
The purpose of this study was to examine the feasibility and effects of an upper extremity gaming system on impairments, activity and participation restrictions in persons with chronic stroke.


METHODS
Nine participants with chronic (5.4 SD 3 years after stroke) upper extremity impairment due to stroke completed 18 sessions over 6 weeks with the Hand Dance Pro™ gaming system that included trunk restraint. Measures collected at pretest and posttest included three-dimensional motion analysis of paretic upper extremity reaching, Wolf Motor Function Test (WMFT) and Stroke Impact Scale (SIS). Data were analyzed across time, with effect sizes (Cohen's d), and by categorizing participants with Fugl-Meyer Upper Extremity Motor Assessment scores (mild >50/66, moderate 26-50/66 and severe <26/66).


RESULTS
Statistically, significant improvements and medium-to-large effect sizes from pretest to posttest were found with ipsilateral reaching kinematic outcomes of movement duration, mean velocity and elbow excursion (p < 0.05). Participants with mild impairment demonstrated the greatest change in elbow excursion. No significant differences and small effect sizes were found for the WMFT and SIS.


CONCLUSIONS
The gaming intervention with high repetitions of reaching to targets and trunk restraint was feasible and led to improvements in upper extremity movement kinematics in this group of participants with chronic stroke.
Krannert School of Physical Therapy, University of Indianapolis, IN 46227, USA. scombs@uindy.edu
Stephanie A
SA
Combs
Margaret A
MA
Finley
Maggie
M
Henss
Stacy
S
Himmler
Kelly
K
Lapota
Danielle
D
Stillwell
D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D002908:Chronic Disease; D015331:Cohort Studies; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation*; D011597:Psychomotor Performance / Q000502:physiology; D020127:Recovery of Function; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D034941:Upper Extremity / Q000503:physiopathology*; D018910:Video Games