Authors (including presenting author) :
Lau KY, Ng HM, Chan CL, Chan HY, Chan WC, Wong ST
Affiliation :
Physiotherapy Department, Haven of Hope Hospital
Introduction :
Stroke is a major cause of disability worldwide. More than half of stroke survivors present with upper limb impairments even during chronic phase. Upper limb RAT with gamification is one of the novel treatments designed for intensive upper limb rehabilitation. It consists of a weight support motorized arm orthosis to provide assist-as-needed guidance for upper limb functional movements. While exergaming, the game is controlled by movements of impaired upper limb. It can motivate patients to engage in training and encourage them to reach the targeted range of movements. Progression can be made by increasing the difficulties of game, increasing the range of movements and decreasing the percentage of upper limb weight support.
Objectives :
To evaluate the effectiveness of upper limb RAT with gamification on hemi-paretic upper extremity function and hand grip strength outcomes in stroke rehabilitation.
Methodology :
One-group pre-posttest design was adopted. 14 stroke survivors with average age of 58 (SD = 13) were recruited in our hospital from August 2023 to December 2024. Patients with poor cognitive function, poor vision, hemiplegic shoulder subluxation, totally flaccid upper limb or prolonged sitting intolerance were excluded. In addition to conventional rehabilitation program, gamified RAT intervention was provided to these patients. Each session was conducted for around 30 minutes. The outcomes were (1) total score of Shortened Fugl-Meyer Assessment Upper Extremity Scale (S-FMA-UE total), which consisted of 6 items with a full score of 12 and (2) paretic hand grip (PHG) in KgF. Wilcoxon signed rank test was applied to compare the changes in S-FMA-UE total. Paired t-test was used to compare the changes in PHG.
Result & Outcome :
Each subject received 17 treatment sessions on average. Both S-FMA-UE total and PHG showed improvement. The median of S-FMA-UE total was increased from 6.5 to 10 (p = 0.001). The PHG showed a significant improvement (mean difference = 2.95kgF; 95% CI 0.60, 5.30kgF; p = 0.018). Gamified RAT intervention in addition to conventional physiotherapy treatment showed positive effect on improving paretic upper limb’s function and hand grip strength in stroke survivors. It can be considered as one of the interventions for upper limb rehabilitation on paretic upper limb.
