Using commercial video games for upper limb stroke rehabilitation: is this the way of the future?
BACKGROUND
The increasing number of people living with poststroke sequelae has stimulated the search for novel ways of providing poststroke rehabilitation without putting additional stress on overburdened health care systems. One of them is the use of commercially available technology and off-the-shelf video games for hemiparetic upper limb rehabilitation.


METHODS
The MEDLINE, EMBASE, and Cochrane Library databases were searched using key word synonyms for stroke, upper limb, and video games. Included studies investigated upper limb stroke rehabilitation using commercially available consoles and video games, reported outcomes that included measures of upper limb functionality, and were published in a peer-reviewed journal written in English.


RESULTS
Thirteen studies were identified - 6 published as full articles and 7 as abstracts. Studies were generally small and only 3 were randomized. The gaming systems investigated were the Nintendo Wii (n = 10), EyeToy PlayStation (n = 2), and CyWee Z (n = 1). The Nintendo Wii appears to provide the greatest benefits to patients, with improvements seen in upper extremity function measures such as joint range of motion, hand motor function, grip strength, and dexterity. Three studies indicate that video therapy appears to be safe and that long-term improvements continue at follow-up.


CONCLUSIONS
At present, the evidence that the use of commercial video games in rehabilitation improves upper limb functionality after stroke is very limited. However, this approach has the potential to provide easily available and affordable stroke rehabilitation therapy in settings where access to therapy is limited by geographical or financial constraints.
Centre for Military and Veterans' Health, Research Coordination Unit, The University of Queensland, Mayne Medical School, Herston, Queensland, Australia.
Eva
E
Pietrzak
Centre for Military and Veterans' Health, Research Coordination Unit, The University of Queensland, Mayne Medical School, Herston, Queensland, Australia.
Cristina
C
Cotea
Centre for Military and Veterans' Health, Research Coordination Unit, The University of Queensland, Mayne Medical School, Herston, Queensland, Australia.
Stephen
S
Pullman
D006801:Humans; D061214:Patient Safety; D017060:Patient Satisfaction; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*; D018910:Video Games / Q000009:adverse effects
poststroke rehabilitation; review; upper limb; video games; virtual reality