The efficacy of Wii-based Movement Therapy for upper limb rehabilitation in the chronic poststroke period: a randomized controlled trial.
BACKGROUND
More effective and efficient rehabilitation is urgently needed to address the prevalence of unmet rehabilitation needs after stroke. This study compared the efficacy of two poststroke upper limb therapy protocols.


OBJECTIVE
We tested the hypothesis that Wii-based movement therapy would be as effective as modified constraint-induced movement therapy for post-stroke upper-limb motor rehabilitation.


METHODS
Forty-one patients, 2-46 months poststroke, completed a 14-day program of Wii-based Movement Therapy or modified Constraint-induced Movement Therapy in a dose-matched, assessor-blinded randomized controlled trial, conducted in a research institute or patient's homes. Primary outcome measures were the Wolf Motor Function Test timed-tasks and Motor Activity Log Quality of Movement scale. Patients were assessed at prebaseline (14 days pretherapy), baseline, post-therapy, and six-month follow-up. Data were analyzed using linear mixed models and repeated measures analysis of variance.


RESULTS
There were no differences between groups for either primary outcome at any time point. Motor function was stable between prebaseline and baseline (P > 0·05), improved with therapy (P < 0·001); and improvements were maintained at six-months (P > 0·05). Wolf Motor Function Test timed-tasks log times improved from 2·1 ± 0·22 to 1·7 ± 0·22 s after Wii-based Movement Therapy, and 2·6 ± 0·23 to 2·3 ± 0·24 s after modified Constraint-induced Movement Therapy. Motor Activity Log Quality of Movement scale scores improved from 67·7 ± 6·07 to 102·4 ± 6·48 after Wii-based Movement Therapy and 64·1 ± 7·30 to 93·0 ± 5·95 after modified Constraint-induced Movement Therapy (mean ± standard error of the mean). Patient preference, acceptance, and continued engagement were higher for Wii-based Movement Therapy than modified Constraint-induced Movement Therapy.


CONCLUSIONS
This study demonstrates that Wii-based Movement Therapy is an effective upper limb rehabilitation poststroke with high patient compliance. It is as effective as modified Constraint-induced Movement Therapy for improving more affected upper limb movement and increased independence in activities of daily living.
Neuroscience Research Australia, Sydney, NSW, Australia.|UNSW Australia, Sydney, NSW, Australia.
Penelope A
http://orcid.org/0000-0002-5227-3719
PA
McNulty
Neuroscience Research Australia, Sydney, NSW, Australia.|UNSW Australia, Sydney, NSW, Australia.
Angelica G
AG
Thompson-Butel
UNSW Australia, Sydney, NSW, Australia.|St Vincent's Hospital, Sydney, NSW, Australia.
Steven G
SG
Faux
Neuroscience Research Australia, Sydney, NSW, Australia.
Gaven
G
Lin
UNSW Australia, Sydney, NSW, Australia.|Prince of Wales Hospital, Sydney, NSW, Australia.
Pesi H
PH
Katrak
Neuroscience Research Australia, Sydney, NSW, Australia.|UNSW Australia, Sydney, NSW, Australia.
Laura R
LR
Harris
Neuroscience Research Australia, Sydney, NSW, Australia.|UNSW Australia, Sydney, NSW, Australia.
Christine T
CT
Shiner
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005081:Exercise Therapy / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D057240:Patient Preference; D012149:Restraint, Physical / Q000379:methods; D012720:Severity of Illness Index; D016037:Single-Blind Method; D020521:Stroke / Q000503:physiopathology* / Q000523:psychology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*; D018910:Video Games
dexterity; independence in activities of daily living; modified Constraint-induced Movement Therapy; motor function; therapy compliance