Patients were positive to using video games in rehabilitation. A sample size of 72 patients (24 per group) would be appropriate for a full study.

The Brunnstrom recovery stages (the BRS) consists of 2 items assessing the poststroke motor function of the upper extremities and 1 assessing the lower extremities. The 3 items together represent overall motor function. Although the BRS efficiently assesses poststroke motor functions, a lack of rigorous examination of the psychometric properties restricts its utility. We aimed to examine the unidimensionality, Rasch reliability, and responsiveness of the BRS, and transform the raw sum scores of the BRS into Rasch logit scores once the 3 items fitted the assumptions of the Rasch model.We retrieved medical records of the BRS (N = 1180) from a medical center. We used Rasch analysis to examine the unidimensionality and Rasch reliability of both upper-extremity items and the 3 overall motor items of the BRS. In addition, to compare their responsiveness for patients (n = 41) assessed with the BRS and the Stroke Rehabilitation Assessment of Movement (STREAM) on admission and at discharge, we calculated the effect size (ES) and standardized response mean (SRM).The upper-extremity items and overall motor items fitted the assumptions of the Rasch model (infit/outfit mean square = 0.57–1.40). The Rasch reliabilities of the upper-extremity items and overall motor items were high (0.91–0.92). The upper-extremity items and overall motor items had adequate responsiveness (ES = 0.35–0.41, SRM = 0.85–0.99), which was comparable to that of the STREAM (ES = 0.43–0.44, SRM = 1.00–1.13).The results of our study support the unidimensionality, Rasch reliability, and responsiveness of the BRS. Moreover, the BRS can be transformed into an interval-level measure, which would be useful to quantify the extent of poststroke motor function, the changes of motor function, and the differences of motor functions in patients with stroke.

No abstract

The purpose of this study was to develop a digital game system for rehabilitation and to assess their feasibility, usability and effectiveness. A questionnaire was designed to evaluate the usability and feasibility associated with using this game. The results of this study can be summarized as follows: 1) the upper extremity rehabilitation gardening game (UERG game) is special designed for domestic stroke patients. 2) This UERG game uses Kinect's skeletal tracking features and motion sensor to interaction with patients. 3) design features are as following: game contents include three difficult levels according to different upper limb motor function recovery stages; to record user's motor performance; to provide feedback information (for example: to record the completed the task time and to detect whether the user has compensatory action, etc.). 4) A total of 10 patients to assess this set of games. The results showed that 90% of patients reported that using UERG game in treatment increased their treatment motivation.; 70% of them reported that this games is very interactive; 80% patients considered this game is conducive to recovery their upper extremity functions; 80% patients considered the feedback information provided help them to understand their performance in each session after training; 60% patients indicated the game interfaces were easy to operate and learning; 90% of patients reported that this game is enjoyment and satisfied with this game for rehabilitation. Overall, the UERG game is feasibility to use in rehabilitation.

These results indicate that it is appropriate for research purposes, but not appropriate for clinical usage, to use proxy reports to measure disability levels in patients with stroke. Furthermore, the two methods should not be used interchangeably to monitor patients because of the wide limits of agreement between patient and proxy reports on the self-administered Barthel Index and self-administered Frenchay Activities Index.