Serious game for rehabilitation of the lower limb of hemiparetics patients after stroke

Abstract

Introduction/Background Hemiparesis is the classic clinical condition of stroke and is related to important locomotor limitations. The treatment strategies traditionally chosen are limited by the monotony, boredom and repetitiveness of the exercises. Serious games (SG) combine specific physical training with a higher attentional and motivational level, increasing adherence to treatment. The aim of this study was to verify the therapeutic effects of exercise program using a SG developed for evaluation and rehabilitation of hemiparetic patients after stroke. Material and method Non-Randomized Controlled Clinical Trial involving 24 patients (12 men) was conducted. Patients were divided into 2 groups. One group consisted in realize exercises with a SG mim-Pong (experimental, Fig. 1 ) and the other group a conventional physical therapy (control). Both groups completed the 20-session treatment protocol. The following variables evaluated were: muscle strength, motor control, motor impairment, spasticity, functional mobility and gait speed. Data were analyzed with descriptive statistics, paired Student's t-test and effect size calculation. Results Patients did not differ in terms of sociodemographic characteristics at baseline. In the experimental group, significant improvements were observed for all variables ( Table 1 ). Large effect sizes were found for muscle strength of hamstrings, quadriceps femoris and hamstrings scores, Fugl-Meyer Assessment Scale and Modified Ashworth Scale. In the control group the improvements were lower than experimental group with small to moderate effect sizes. Significant differences were found only for game scores (QFS and HS) probably due to learning during the training phase conducted before assessment with the SG. Conclusion These results suggest that SG promote superior improvements to those obtained with conventional treatment of hemiparetic patients after stroke. This superiority is probably due to increased attention demand and motivation during interventions with SG.