title: A Rehabilitation First-Tournament Between Teams of Nursing Home Residents with Chronic Stroke.
abstract: OBJECTIVE
  This study describes the BrightArm™ Duo virtual reality system (Bright Cloud International Corp., Highland Park, NJ) and determines its clinical benefit for maintenance of upper extremity function in nursing home residents who are chronic poststroke.
  
  
  METHODS
  Participants sat at a low-friction robotic table with tilt and lift capability and interacted with serious games through computerized supports that measured forearm movement and grasp. The rehabilitation simulations were designed to improve arm and hand function, increase range of motion, and improve emotional well-being and cognition (attention, memory, and executive functioning). After 8 weeks of initial intensive therapy, there were three booster periods at 8-week intervals, each consisting of four sessions over 2 weeks. The last booster was a tournament competition, where pairs of residents played games collaboratively from remote nursing homes. Participants were evaluated before and after each booster period using standardized clinical measures.
  
  
  RESULTS
  Range of motion improved for 18 out of 23 upper extremity movement variables (P = 0.01) between pre- and post-tournament assessment, and the residents self-reported that they enjoyed playing with a partner (score of 4.7 out of 5.0). Participants were able to reduce game completion time through cooperative play (teamwork), and the times improved with successive sessions of the tournament. Affected hand and arm function and depression levels were maintained (no decline) after the tournament.
  
  
  CONCLUSIONS
  A rehabilitation tournament using virtual reality between teams of nursing home residents chronic poststroke is the first of its kind in clinical practice. This study demonstrates its effectiveness in improving range of motion of the upper extremity while engaging residents in the maintenance program at their nursing home.
authors.affiliation: 1 Bright Cloud International Corp , Highland Park, New Jersey.
authors.forename: Gregory
authors.initials: G
authors.lastname: House
authors.affiliation: 1 Bright Cloud International Corp , Highland Park, New Jersey.
authors.forename: Grigore
authors.initials: G
authors.lastname: Burdea
authors.affiliation: 1 Bright Cloud International Corp , Highland Park, New Jersey.
authors.forename: Kevin
authors.initials: K
authors.lastname: Polistico
authors.affiliation: 1 Bright Cloud International Corp , Highland Park, New Jersey.
authors.forename: Namrata
authors.initials: N
authors.lastname: Grampurohit
authors.affiliation: 1 Bright Cloud International Corp , Highland Park, New Jersey.
authors.forename: Doru
authors.initials: D
authors.lastname: Roll
authors.affiliation: 2 Roosevelt Care Center , Edison, New Jersey.
authors.forename: Frank
authors.initials: F
authors.lastname: Damiani
authors.affiliation: 3 JFK Hartwyck at Edison Estates , Edison, New Jersey.
authors.forename: Samantha
authors.initials: S
authors.lastname: Keeler
authors.affiliation: 4 Hundal Neuropsychology Group , Watchung, New Jersey.
authors.forename: Jasdeep
authors.initials: J
authors.lastname: Hundal
mesh_terms: D003198:Computer Simulation; D003863:Depression / Q000628:therapy; D018737:Hand Strength / Q000502:physiology; D009068:Movement / Q000502:physiology; D010291:Paresis / Q000503:physiopathology / Q000628:therapy*; D016059:Range of Motion, Articular / Q000502:physiology*; D000071939:Stroke Rehabilitation / Q000379:methods*; D034941:Upper Extremity / Q000503:physiopathology; D014584:User-Computer Interface; D018910:Video Games