Commercial gaming devices for stroke upper limb rehabilitation: a survey of current practice

Abstract Purpose: Stroke upper limb impairment is associated with disability in activities of daily living. Gaming (Nintendo Wii) is being introduced to rehabilitation despite limited evidence regarding effectiveness. Little data exists on how gaming is implemented resulting in a lack of clinical information. We aimed to gather therapists’ opinions on gaming. Methods: A survey was posted to therapists, identified from stroke services across Scotland. A second survey was posted to non-responders. Survey data were analysed using descriptive statistics and thematic coding. Results: Surveys were sent to 127 therapists (70 stroke services) and returned by 88% (112/127). Gaming was used by 18% of therapists, 61% (68/112) stated they would use this intervention should equipment be available. The most commonly used device was Nintendo Wii (83% of therapists using gaming) for 30 min or less once or twice per week. Half of therapists (51%) reported observing at least one adverse event, such as fatigue, stiffness or pain. Gaming was reported to be enjoyable but therapists described barriers, which relate to time, space and cost. Conclusions: Gaming is used by almost a fifth of therapists. Adverse events were reported by 51% of therapists; this should be considered when recommending use and dosage. Implications for Rehabilitation Commercial gaming devices are reported to be used by 1/5th of therapists for stroke upper limb rehabilitation, 3/5ths would use gaming if available. Adverse events were reported by 51% of therapists; this should be considered when recommending use and dosage. Current use of gaming in practice may not be achieving intense and repetitive upper limb task-specific practice.

[1]  P. Celnik,et al.  Stroke Rehabilitation. , 2015, Physical medicine and rehabilitation clinics of North America.

[2]  A. M. Pettersen,et al.  Subjective well-being one year after stroke , 1997, Clinical rehabilitation.

[3]  A. Prevo,et al.  The long-term outcome of arm function after stroke: results of a follow-up study. , 1999, Disability and rehabilitation.

[4]  Thompson G. Robinson,et al.  National Clinical Guidelines for Stroke. , 2001 .

[5]  Subashan Perera,et al.  Persisting Consequences of Stroke Measured by the Stroke Impact Scale , 2002, Stroke.

[6]  Caring for patients with hemiplegia in an arm following a stroke. , 2004, British journal of nursing.

[7]  P. Heuschmann,et al.  Standard method for developing stroke registers in low-income and middle-income countries: experiences from a feasibility study of a stepwise approach to stroke surveillance (STEPS Stroke) , 2007, The Lancet Neurology.

[8]  S. Flynn,et al.  Feasibility of Using the Sony PlayStation 2 Gaming Platform for an Individual Poststroke: A Case Report , 2007, Journal of neurologic physical therapy : JNPT.

[9]  H. Krebs,et al.  Effects of Robot-Assisted Therapy on Upper Limb Recovery After Stroke: A Systematic Review , 2008, Neurorehabilitation and neural repair.

[10]  D. Rand,et al.  The Sony PlayStation II EyeToy: Low-Cost Virtual Reality for Use in Rehabilitation , 2008, Journal of neurologic physical therapy : JNPT.

[11]  M. Clarke,et al.  Methods to increase response to postal and electronic questionnaires , 2023, The Cochrane database of systematic reviews.

[12]  P. Langhorne,et al.  Motor recovery after stroke: a systematic review , 2009, The Lancet Neurology.

[13]  M Massucci,et al.  Is health-related-quality of life of stroke patients influenced by neurological impairments at one year after stroke? , 2010, European journal of physical and rehabilitation medicine.

[14]  W. McIlroy,et al.  Effectiveness of Virtual Reality Using Wii Gaming Technology in Stroke Rehabilitation: A Pilot Randomized Clinical Trial and Proof of Principle , 2010, Stroke.

[15]  P. Langhorne,et al.  Stroke rehabilitation , 2011, The Lancet.

[16]  P. McNulty,et al.  Wii-based movement therapy to promote improved upper extremity function post-stroke: a pilot study. , 2011, Journal of rehabilitation medicine.

[17]  J. Deutsch,et al.  Virtual Reality for Stroke Rehabilitation , 2012 .

[18]  Mark D. Huffman,et al.  Heart disease and stroke statistics--2013 update: a report from the American Heart Association. , 2013, Circulation.

[19]  Marie Donaghy,et al.  Predicting health related quality of life 6 months after stroke: the role of anxiety and upper limb dysfunction , 2013, Disability and rehabilitation.

[20]  M. Brainin,et al.  European Stroke Organisation , 2013 .

[21]  I. Swain,et al.  Treatment components for upper limb rehabilitation after stroke: a survey of UK national practice , 2014, Disability and rehabilitation.

[22]  T. Stevenson,et al.  Is time spent using constraint induced movement therapy an appropriate measure of dose , 2014 .

[23]  Katie Thomson,et al.  Commercial Gaming Devices for Stroke Upper Limb Rehabilitation: A Systematic Review , 2014, International journal of stroke : official journal of the International Stroke Society.

[24]  G. Mead,et al.  Interventions for improving upper limb function after stroke. , 2014, The Cochrane database of systematic reviews.

[25]  Ian Swain,et al.  Assistive technologies: can they contribute to rehabilitation of the upper limb after stroke? , 2014, Archives of physical medicine and rehabilitation.