Abstract
BackgroundMovement-based priming has been increasingly investigated to accelerate the effects of subsequent motor training. The feasibility and acceptability of this approach at home has not been studied. We developed a game-based priming system (DIG-I-PRIMETM) that engages the user in repeated ankle movements using serious games. We aimed to determine the feasibility, acceptability, and preliminary motor benefits of an 8-week remotely supervised telerehabilitation program utilizing game-based movement priming combined with functional lower limb motor training in chronic stroke survivors.MethodsThree individuals with stroke participated in a telerehabilitation program consisting of 20-min movement-based priming using the DIG-I-PRIMETM system followed by 30-min of lower limb motor training focusing on strength and balance. We evaluated feasibility using reported adverse events and compliance, and acceptability by assessing participant perception of the game-based training. Motor gains were assessed using the 10-m walk test and Functional Gait Assessment.ResultsAll participants completed 24 remotely supervised training sessions without any adverse events. Participants reported high acceptability of the DIG-I-PRIMETM system, reflected by high scores on satisfaction, enjoyment, user-friendliness, and challenge aspects of the system. Participants reported overall satisfaction with our program. Post-training changes in the 10-m walk test (0.10–0.31 m/s) and Functional Gait Assessment (4–7 points) exceeded the minimal clinically important difference.ConclusionOur results indicate that a remotely supervised game-based priming and functional lower limb exercise program is feasible and acceptable for stroke survivors to perform at home. Also, improved walking provides preliminary evidence of game-based priming to be beneficial as a telerehabilitation strategy for stroke motor recovery.
Highlights
Post-stroke individuals experience barriers that limit access to necessary physical or occupational therapy that is critical to regain and maintain motor function
We recently demonstrated a significant priming effect in chronic stroke survivors after 20 min of repeated movements of the paretic ankle during serious game playing using the DIG-I-PRIMETM system in the laboratory [20]
Participant 1 (P1) was a 55-year-old Hispanic male with hemorrhagic stroke with unknown lesion location presenting with right-sided hemiparesis
Summary
Post-stroke individuals experience barriers that limit access to necessary physical or occupational therapy that is critical to regain and maintain motor function. Some of these barriers include health care costs, time to travel, lack of transportation, lack of available resources in hospitals/clinics, lack of caregiver support, etc., and these barriers have only become greater in the era of COVID-19 pandemic [1]. We aimed to determine the feasibility, acceptability, and preliminary motor benefits of an 8-week remotely supervised telerehabilitation program utilizing game-based movement priming combined with functional lower limb motor training in chronic stroke survivors
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