Feasibility of integrative games and novel therapeutic game controller for telerehabilitation of individuals chronic post-stroke living in the community

Grigore C. Burdea, Namrata Grampurohit, Nam Kim, Kevin Polistico, Ashwin Kadaru, Simcha Pollack, Mooyeon Oh-Park, A. M. Barrett, Emma Kaplan, Jenny Masmela, Phalgun Nori

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background: Intensive, adaptable and engaging telerehabilitation is needed to enhance recovery and maximize outcomes. Such services may be provided under early supported discharge, or later for chronic populations. A novel virtual reality game-based telerehabilitation system was designed for individuals post-stroke to enhance their bimanual upper extremity motor function, cognition, and wellbeing. Objectives: To evaluate the feasibility of novel therapeutic game controller and telerehabilitation system for home use. Methods: Individuals chronic post-stroke and their caregivers were recruited (n = 8 + 8) for this feasibility study. One was a screen failure and seven completed 4 weeks (20 sessions) of home-based therapy with or without remote monitoring. Standardized clinical outcome measures were taken pre- and post-therapy. Game performance outcomes were sampled at every session, while participant and caregiver subjective evaluations were done weekly. Results: There was a 96% rate of compliance to protocol, resulting in an average of 13,000 total arm repetitions/week/participant. Group analysis showed significant (p <.05) improvements in grasp strength (effect size [ES] = 0.15), depression (Beck Depression Inventory II, ES = 0.75), and cognition (Neuropsychological Assessment Battery for Executive Function, ES = 0.46). Among the 49 outcome variables, 36 variables (73.5%) improved significantly (p =.001, binomial sign test). Technology acceptance was very good with system rating by participants at 3.7/5 and by caregivers at 3.5/5. Conclusions: These findings indicate the feasibility and efficacy of the system in providing home-based telerehabilitation. The BrightBrainer system needs to be further evaluated in randomized control trials and with individuals early post-stroke.

Original languageEnglish (US)
Pages (from-to)321-336
Number of pages16
JournalTopics in Stroke Rehabilitation
Volume27
Issue number5
DOIs
StatePublished - Jul 3 2020

All Science Journal Classification (ASJC) codes

  • Rehabilitation
  • Community and Home Care
  • Clinical Neurology

Keywords

  • Adaptable gamification
  • BrightGrasp
  • caregiver
  • integrative medicine
  • stroke
  • telerehabilitation

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