Game-Based Virtual Reality Canoe Paddling Training to Improve Postural Balance and Upper Extremity Function: A Preliminary Randomized Controlled Study of 30 Patients with Subacute Stroke

Abstract

BackgroundVirtual reality (VR) training with motion-controlled console games can be incorporated into stroke rehabilitation programs. The use of a variety of gaming software can provide the patient with an opportunity to perform activities that are exciting, entertaining, and that may not be feasible in clinical environments. The aim of this preliminary randomized controlled study was to investigate the effects of game-based VR canoe paddling training, when combined with conventional physical rehabilitation programs, on postural balance and upper extremity function in 30 patients with subacute stroke.Material/MethodsThirty patients, who were within six months following the diagnosis of stroke, were randomly allocated to either the experimental group (n=15) or the control group (n=15). All participants participated in a conventional rehabilitation program. Also, the experimental group (n=15) performed the VR canoe paddling training for 30 minutes each day, three times per week, for five weeks. After five weeks, outcomes of changes in postural balance and upper extremity function were evaluated and compared between the two groups.ResultsAt five weeks, postural balance and upper extremity function showed significant improvements in both patients groups when compared with the baseline measurements (p<0.05). However, postural balance and upper extremity function were significantly improved in the experimental group when compared with the control group (p<0.05).ConclusionsGame-based VR canoe paddling training is an effective rehabilitation therapy that enhances postural balance and upper extremity function in patients with subacute stroke when combined with conventional physical rehabilitation programs.

Effectiveness of Virtual Reality in the Rehabilitation of Motor Function of Patients With Subacute Stroke: A Meta-Analysis

“…However, the remaining studies used the terms “virtual reality intervention” and “game-based intervention” interchangeably. For instance, their treatment protocols incorporated the use of different gaming-based engines or systems, such as the Xbox Kinect system ( 45 , 52 ), Unity 3D game engine ( 22 ), Nintendo Wii Sports Resort package ( 12 , 21 , 23 , 47 , 53 ), the YouGrabber system ( 56 ), Jintronix Rehabilitation system ( 49 ), and PlayStation console ( 50 ).…”

“…That being said, the number of studies investigating the effect of VR-based interventions in patients with subacute stroke remains scarce (9,(21)(22)(23), and no conclusions have been reached in this regard. This topic is of great interest because (1) the plasticity of the brain remains good during the acute and subacute phase (24,25) and (2) the effectiveness of rehabilitation therapy-induced neuroplasticity is limited in chronic stroke patients, particularly those who missed the window of opportunity that is present during the subacute phase (when the brain plasticity peaks) (26).…”

Gamifying Motor Rehabilitation Therapies: Challenges and Opportunities of Immersive Technologies

“…When adding immersive technologies to the equation, VR-based rehabilitation has shown to have the following documented advantages; increased repetitions over the proposed exercises and augmented patient engagement; the capacity to track the patient's recovery process over time; possibility of requiring low clinical supervision, which indeed eases home use and tele-rehabilitation; and enhanced motor (re)learning by different types of stimuli (visual, auditory or haptics) [10,28,36]. Nevertheless, playing SGs has also shown to be crucial in stimulating the development of basic learning skills, such as paying attention, promoting visual-motor coordination, improving logical spatial reasoning and orientation, among others [37,38].…”

Rehabilitation for balance impairment in patients after stroke: a protocol of a systematic review and network meta-analysis

“…WBV is able to improve results of the Functional Reach Test and the Timed Up and Go (TUG) test, which have a positive effect on the balance and gait function of patients who had a stroke 20. Results of an RCT concluded that VR is an effective rehabilitation therapy which can improve postural balance and upper extremity function in patients who had a stroke 21. Exercises such as bilateral upper extremity exercises,22 step climbing exercise23 and trampoline training24 are beneficial to the ability to balance and for fall prevention.…”