Effects of Game-Based Task-Oriented Circuit Training on Physical Functions of Stroke Survivors: A Pilot Study in A State Hospital in Kelantan, Malaysia

Abstract

Despite being increasingly popular and commonly used in rehabilitation, both game-based exercise training and task-oriented circuit training have never been combined to provide a new training experience for stroke survivors undergoing rehabilitation. Past studies have assessed the effectiveness of these exercise approaches separately and reported positive outcomes. Combining the two training programs may create a more enriched environment and yield favorable outcomes. The aim of this study was to determine the effects of game-based task-oriented circuit training on the physical functions of stroke survivors. This research was a pretest-posttest experimental pilot trial involving 30 participants at post-acute and chronic stage post-stroke (mean age and standard deviation = 58.9 ± 6.6 years; mean Montreal Cognitive Assessment scoring = 23.4 ± 7.1) conducted at a state hospital in Kelantan, Malaysia between August 2019 to February 2020. All participants received game-based task-oriented circuit training using a “Checkercise Board” for 45 minutes, twice per week for 8 weeks. The outcome of the training was measured with regard to lower limb strength, functional stability and aerobic capacity, with the use of the 30-second chair rise test, Dynamic Gait Index (DGI) and 6-minute walk test, respectively. Analysis was done by the ‘intention-to-treat’ approach, using paired samples t-test to determine the differences between pre and post-training outcomes scores. All data was analyzed using the Statistics Package for the Social Sciences (SPSS), version 23.0. The significance level was set at p < 0.05 and Cohen’s (d) was used to determine the effect size. Post-training, participants’ mean 30-second chair rise test, DGI and 6-minute walk test scores increased by 9%, 7% and 23% respectively compared to pre-treatment (p < 0.05), with medium effect size of 0.5 to 0.6. Game-based task-oriented circuit training effectively improves lower limb strength, functional stability and aerobic capacity of stroke survivors, and may be used as a therapy option for this population. A future study is needed to confirm these study finding.