Eliciting Upper Extremity Purposeful Movements Using Video Games

Video games have become popular in stroke rehabilitation; however, the nature of this intervention isn’t understood completely. To compare the number of (a) purposeful and nonpurposeful repetitions of the weaker upper extremity (UE) and (b) movement accelerations as assessed by accelerometer activity counts of the weaker and stronger UEs of individuals with chronic stroke while playing video games or receiving in traditional therapy. Twenty-nine individuals (mean age 59 years, 1-7 years poststroke) took part in a group intervention of video -games (n = 15) or traditional therapy (n = 14) as part of a randomized controlled trial. During 1 – 2 sessions, participants were video-taped while wearing wrist accelerometers. Assessors counted the number of repetitions and classified movements as purposeful or nonpurposeful using videotapes. The weaker UE motor impairments were correlated to movement accelerations, to determine if participants were using their potential during the sessions. Participants in the video game group completed a median of 271 purposeful movements and 37 970 activity counts compared to 48 purposeful movements and 14 872 activity counts in the traditional group (z = -3.0, P = .001 and z = -1.9, P = .05, respectively). Participants in the traditional group completed a median of 26 nonpurposeful (exercises) in comparison with 0 in the video game group (z = -4.2, P = .000). Strong significant correlations were found between the motor ability of the weak UE to repetitions of participants in both groups (r = .86, P < .01). Participants with higher motor ability performed more repetitions.

Video games prompted more UE purposeful repetitions and higher acceleration of movement in comparison with traditional therapy in persons with chronic stroke.

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