COMPUTER GAME-BASED REHABILITATION FOR POSTSTROKE UPPER LIMB DEFICITS- SYSTEMATIC REVIEW AND META-ANALYSIS
DOI:
https://doi.org/10.15621/ijphy/2020/v7i1/193674Keywords:
Stroke, rehabilitation, upper limb, computer games, technological advances, non-immersive rehabilitation.Abstract
Background: The need for intense rehabilitation protocols with easy applicability to improve for patient adherence and harness the potential neuroplasticity leading to improvement in the quality of life (QOL) in post-stroke patients. Several studies have described the benefits of virtual reality and video games in rehabilitation.
Aims: To explore and determine if Computer game-based rehabilitation for post-stroke upper limb deficits after stroke is superior to conventional therapy in terms of (1) ICIDH based outcomes (2) Intervention duration (3) acceptability and adherence to the intervention.
Methods: This systematic review and meta-analysis followed PRISMA guidelines. Several electronic databases were searched using specific keywords, to measure the effects of computer-game-based therapy in post-stroke patients compared to conventional therapy.
Results: 14 studies were included after a systematic review, out of which 11 were included for analysis. Studies recording Wolf motor function test and box and block test have shown improvements with Computer-game-based therapy in addition to conventional therapy. No improvements were recorded in impairments and patient participation/Quality of life. CGBT was acceptable and reported no adverse effects.
Conclusions: Computer-game-based therapy or non-immersive virtual rehabilitation is effective and acceptable for upper limb rehabilitation after stroke. With significant improvement in ‘activity-limitation,’ this mode of rehabilitation can be adapted for patient-specific needs. Its effects on impairment and quality of life need further exploration.
References
Feigin VL, Krishnamurthi RV, Parmar P. Update on the Global Burden of Ischemic and Hemorrhagic Stroke in 1990-2013: The GBD 2013 Study Neuroepidemiology 2015;45(3):161-76.
Feigin VL, Roth GA, Naghavi M. Global burden of stroke and risk factors in 188 countries, during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet Neurol 2016;15(9):913-24.
Hata J, Kiyohara Y. Epidemiology of stroke and coronary artery disease in Asia. Circ J. 2013;77(8):1923-32
Kwakkel G, Veerbeek JM, van Weegen EE, Wolf SL. Constraint-Induced Movement Therapy after Stroke. Lancet Neurol. 2015;14(2):224–34.
Kwakkel G, Boudewijn J, Jeroen V, Arie JH. Probability of Regaining Dexterity in the Flaccid Upper Limb Impact of Severity of Paresis and Time since Onset in Acute Stroke. Stroke. 2003;34:2181-6.
Langhorne P, Wagenaar R, Partridge C. Physiotherapy after stroke: more is better? Physiother Res Int. 1996;1(2):75-88.
Kwakkel G, Wagenaar RC, Koelman TW, Lankhorst GJ, Koetsier JC. Effects of intensity of rehabilitation after stroke. A research synthesis. Stroke. 1997;28(8):1550-6.
Plautz EJ, Milliken GW, Nudo RJ. Effects of Repetitive Motor Training on Movement Representations in Adult Squirrel Monkeys: Role of Use versus Learning. Neurobiology of Learning and Memory. 2000;74(1):27-55.
Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurol. 2009;8(8):741-54.
Krakauer JW, Carmichael ST, Dale Corbett D and Wittenberg GF. Getting Neurorehabilitation Right: What Can Be Learned From Animal Models? Neurorehabil and Neural Repair 2012; 26(8):923–931
Barreca S, Wolf SL, Fasoli S and Bohannon R. Treatment interventions for the paretic upper limb of stroke survivors: a critical review Neurorehabil Neural Repair. 2003;17(4):220-6.
Kleim JA, Jones TA. Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. J Speech Lang Hear Res. 2008 51(1):225-39.
Kwakkel G, van PR, Wagenaar RC, Wood DS, Richards C, Ashburn A, et al. Effects of augmented exercise therapy time after stroke: a meta-analysis. Stroke. 2004;35(11):2529-39.
Kwakkel G, van PR, Wagenaar RC, Wood DS, Richards C, Ashburn A, et al. Effects of augmented exercise therapy time after stroke: a meta-analysis. Stroke. 2004;35(11):2529-39.
Dworzynski K, Ritchie G, Fenu E, MacDermott KGP, Playford ED et al. on behalf of the Guideline Development Group. Rehabilitation after stroke: summary of NICE guidance BMJ. 2013;346:f3615.
Argyrides A, Paley L, Kavanagh M, McCurran V, Andrews R, Vestesson E, et al. Royal College of Physicians. Clinical Effectiveness and Evaluation Unit on behalf of the Intercollegiate Stroke Working Party Sentinel Stroke Natinoal Audit Programme (SSNAP) – Clinical audit second pilot public report. 2014.
Otterman NM, vanderWees PJ, Bernhardt J and Kwakkel G. Physical therapists' guideline adherence on early mobilization and intensity of practice at dutch acute stroke units: a country-wide survey. Stroke. 2012;43(9):2395-401.
The ATTEND collaborative group. Family-led rehabilitation after stroke in India (ATTEND): a randomised controlled trial. Lancet 2017;390:588–99.
Page. On “Modified constraint-induced therapy... ” Letter to editor. Physical Therapy. 2008;88:333–40.
Wade E and Winstein CJ. Virtual reality and robotics for stroke rehabilitation: where do we go from here? Top Stroke Rehabil. 2011;18(6):685-700.
Thomson K, Pollock A, Bugge C and Brady B et al. Commercial gaming devices for stroke upper limb rehabilitation: A systematic review. International Journal of Stroke. 2014;9:479–88.
Bonnechèrea B, Bart J, Lubos O and Jan SVS. The use of commercial video games in rehabilitation: a systematic review. International Journal of Rehabilitation Research. 2016;39(4):277-90
Lam YS, Man DW, Tam SF and Weiss PL. Virtual reality training for stroke rehabilitation. NeuroRehabilitation 2006;21:245–253.
Lam YS, Man DW, Tam SF and Weiss PL. Virtual reality training for stroke rehabilitation. NeuroRehabilitation 2006;21:245–253.
Published
Abstract Display: 1149 
PDF Downloads: 918 How to Cite
Issue
Section
Copyright © Author(s) retain the copyright of this article.
This work is licensed under a