Effects of Video-Game Based Therapy on Balance, Postural Control, Functionality, and Quality of Life of Patients with Subacute Stroke: A Randomized Controlled Trial
María José Cano-Mañas, Susana Collado-Vázquez, J R Hernández Hernández, Antonio Jesús Muñoz Villena, Roberto Cano‐de‐la‐Cuerda
Abstract
Purpose . To determine the effects of a structured protocol using commercial video games on balance, postural control, functionality, quality of life, and level of motivation in patients with subacute stroke. Methods . A randomized controlled trial was conducted. A control group ( n = 25) received eight weeks of conventional rehabilitation consisting of five weekly sessions based on an approach for task-oriented motor training. The experimental group ( n = 23) received conventional rehabilitation + video-game based therapy for eight weeks with commercial video games using the Xbox 360° video games console and the Kinect® device with the same total treatment time for both groups. The Modified Rankin Scale, Barthel Index, Tinetti scale, Functional Reach test, Get Up and Go test, Baropodometry, EuroQoL 5D (EQ-5D), satisfaction, adherence, and motivation were used as outcome measures. Results . In the between-group comparison, statistically significant differences were observed in the Modified Rankin scores (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mrow><mml:mi>p</mml:mi><mml:mo><</mml:mo><mml:mn>0.01</mml:mn></mml:mrow></mml:math>), the Barthel Index (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mrow><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.05</mml:mn></mml:mrow></mml:math>), the Tinetti gait assessment (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mrow><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.02</mml:mn></mml:mrow></mml:math>), the Functional Reach test (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mrow><mml:mi>p</mml:mi><mml:mo><</mml:mo><mml:mn>0.01</mml:mn></mml:mrow></mml:math>), the Get Up and Go test (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M5"><mml:mrow><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.05</mml:mn></mml:mrow></mml:math>), the pain/discomfort dimension (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M6"><mml:mrow><mml:mi>p</mml:mi><mml:mo><</mml:mo><mml:mn>0.01</mml:mn></mml:mrow></mml:math>), and anxiety/depression dimension (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M7"><mml:mrow><mml:mi>p</mml:mi><mml:mo><</mml:mo><mml:mn>0.01</mml:mn></mml:mrow></mml:math>) of the EQ-5D and the VAS (visual analog scale) (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M8"><mml:mrow><mml:mi>p</mml:mi><mml:mo><</mml:mo><mml:mn>0.01</mml:mn></mml:mrow></mml:math>) on the perceived health status based on the EQ-5D questionnaire. Regarding the scale of motivation, self-esteem, and adherence, statistically significant differences were achieved in motivation (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M9"><mml:mrow><mml:mi>p</mml:mi><mml:mo><</mml:mo><mml:mn>0.01</mml:mn></mml:mrow></mml:math>), self-esteem (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M10"><mml:mrow><mml:mi>p</mml:mi><mml:mo><</mml:mo><mml:mn>0.01</mml:mn></mml:mrow></mml:math>), and adherence (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M11"><mml:mrow><mml:mi>p</mml:mi><mml:mo><</mml:mo><mml:mn>0.01</mml:mn></mml:mrow></mml:math>) variables. Conclusion . A protocol of semi-immersive video-game based therapy, combined with conventional therapy, may be effective for improving balance, functionality, quality of life, and motivation in patients with subacute stroke. This trial is registered with NCT03528395 .