The Efficacy of Wii-Based Movement Therapy for Upper Limb Rehabilitation in the Chronic Poststroke Period: A Randomized Controlled Trial

McNulty, Penelope A.; Thompson-Butel, Angelica G.; Faux, Steven; Lin, Gaven; Katrak, Pesi; Harris, Laura R.; Shiner, Christine T.

doi:10.1111/ijs.12594

Cited by 63 publications

(111 citation statements)

References 15 publications

(34 reference statements)

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“…As detailed in Hesam-Shariati et al (42), the clinical assessment results for all patients (but not NMF analyses) have been published previously [see Ref. (44) n = 20; (38) n = 9; and (40) n = 8].…”

Section: Methodsmentioning

confidence: 99%

“…(42)]. This therapy uses the Nintendo Wii and Wii-Sports games (Nintendo, Japan) as a rehabilitation tool that targets movement quality and independence in activities of daily living (38, 39). The movements required in Wii-Sports were modified according to the capacity, range of motion, and strength of each patient.…”

Section: Methodsmentioning

confidence: 99%

“…In this study, we extracted muscle synergies during a complex task to investigate the changes in muscle activation profiles (i.e., muscle synergies) in chronic stroke during an intensive 14-day protocol, in this case Wii-based Movement Therapy (WMT) (38, 39). This therapy is as effective as the current best practice in stroke rehabilitation, Constraint-induced Movement Therapy (38, 40). The primary aim of this study was not the therapy itself, but to quantify poststroke muscle synergies during therapy.…”

Section: Introductionmentioning

confidence: 99%

“…Muscle synergy analysis cannot be used to investigate recovery mechanisms occurring in the brain but was used here as a neurophysiological indication to distinguish the level of impairment and the effect of therapy on coordinated muscle activation (41). To identify some of the neuromuscular mechanisms underpinning the improvement reported using clinical motor-function assessments (38, 39), NMF was applied to the EMG recorded from six muscles of the more-affected arm and upper body during the Wii-baseball component of WMT. This longitudinal study examined EMG at early and late therapy, and at 6-month follow-up for a subset of patients.…”

Section: Introductionmentioning

confidence: 99%

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A Longitudinal Electromyography Study of Complex Movements in Poststroke Therapy. 2: Changes in Coordinated Muscle Activation

et al. 2017

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Fine motor control is achieved through the coordinated activation of groups of muscles, or “muscle synergies.” Muscle synergies change after stroke as a consequence of the motor deficit. We investigated the pattern and longitudinal changes in upper limb muscle synergies during therapy in a largely unconstrained movement in patients with a broad spectrum of poststroke residual voluntary motor capacity. Electromyography (EMG) was recorded using wireless telemetry from 6 muscles acting on the more-affected upper body in 24 stroke patients at early and late therapy during formal Wii-based Movement Therapy (WMT) sessions, and in a subset of 13 patients at 6-month follow-up. Patients were classified with low, moderate, or high motor-function. The Wii-baseball swing was analyzed using a non-negative matrix factorization (NMF) algorithm to extract muscle synergies from EMG recordings based on the temporal activation of each synergy and the contribution of each muscle to a synergy. Motor-function was clinically assessed immediately pre- and post-therapy and at 6-month follow-up using the Wolf Motor Function Test, upper limb motor Fugl-Meyer Assessment, and Motor Activity Log Quality of Movement scale. Clinical assessments and game performance demonstrated improved motor-function for all patients at post-therapy (p < 0.01), and these improvements were sustained at 6-month follow-up (p > 0.05). NMF analysis revealed fewer muscle synergies (mean ± SE) for patients with low motor-function (3.38 ± 0.2) than those with high motor-function (4.00 ± 0.3) at early therapy (p = 0.036) with an association trend between the number of synergies and the level of motor-function. By late therapy, there was no significant change between groups, although there was a pattern of increase for those with low motor-function over time. The variability accounted for demonstrated differences with motor-function level (p < 0.05) but not time. Cluster analysis of the pooled synergies highlighted the therapy-induced change in muscle activation. Muscle synergies could be identified for all patients during therapy activities. These results show less complexity and more co-activation in the muscle activation for patients with low motor-function as a higher number of muscle synergies reflects greater movement complexity and task-related phasic muscle activation. The increased number of synergies and changes within synergies by late-therapy suggests improved motor control and movement quality with more distinct phases of movement.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Longitudinal Electromyography Study of Complex Movements in Poststroke Therapy. 2: Changes in Coordinated Muscle Activation

et al. 2017

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“…Finally, visual games in robotic devices replaced the exercises that could be performed and had positive effects because they stimulated patient's internal competitive spirit, and improved treatment compliance and satisfaction. The game programs improved interest and pleasure during treatment, thereby facilitating motor learning and recovery (15,(26)(27)(28). In our study, the treatment response of the patients was similar to the results of previous studies.…”

Section: Discussionmentioning

confidence: 99%

Effects of newly developed compact robot-aided upper extremity training system (Neuro-X®) in patients with stroke: A pilot study

Kim¹,

Won²,

Seo³

et al. 2018

J Rehabil Med

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LAY ABSTRACTAlthough robot-assisted rehabilitation therapy of the upper extremity after stroke has been widely studied, robotic devices are still expensive and voluminous. This newly developed compact upper extremity training system (Neuro-X®) was inexpensive, small-sized, easy to move, and has two muscle strength measurements and six treatment modes. We aimed to evaluate the effects of newly developed compact Neuro-X® system in patients with chronic stroke. Neuro-X® training system can improve the function of the upper extremity and cognition in patients with stroke after six weeks of training and be used for functional recovery of the upper extremity in patients with stroke.Objective: Robot-assisted rehabilitation therapy of the upper extremity after stroke has been studied widely; however, robotic devices remain expensive and bulky. The aim of this study was to evaluate the effects of a newly developed, compact upper extremity training system (Neuro-X®) in patients with chronic stroke. Design: Pilot study. Subjects: Fifteen patients with hemiplegia. Methods: Chronic patients with stroke underwent upper extremity training using a newly developed upper extremity training system (Neuro-X®; Apsun Inc., Seoul, Korea). Patients were evaluated using the Fugl-Meyer Assessment (FMA), Hand Function Test (HFT), Modified Ashworth Scale (MAS), and Korean Mini-Mental Status Evaluation (K-MMSE).The assessment started with "pre 1 evaluation" (A 1 ), followed by repeated "pre 2 evaluation" (A 2 ) after 6 weeks without receiving any treatment, in order to generate repeated baseline data. After the A 2 evaluation, upper extremity training was performed for 6 weeks. Post-training evaluation (B) was performed after treatment. Obtained data (A 1 -A 2 -B) were compared. Results: During the non-intervention phase (A 1 to A 2 ), no significant changes were found in the aforementioned evaluations. However, in the intervention phase (A 2 to B), results of the FMA and HFT, and K-MMSE scores, except the MAS score, increased significantly (p < 0.05). Conclusion: The Neuro-X® training system improves functioning of the upper extremity and cognition in patients with stroke after 6 weeks of training.

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Virtual reality for stroke rehabilitation

Laver

George

Thomas

et al. 2015

Cochrane Database of Systematic Reviews

654

251

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Background Virtual reality and interactive video gaming have emerged as recent treatment approaches in stroke rehabilitation. In particular, commercial gaming consoles have been rapidly adopted in clinical settings. This is an update of a Cochrane Review published in 2011. Objectives Primary objective: To determine the efficacy of virtual reality compared with an alternative intervention or no intervention on upper limb function and activity. Secondary objective: To determine the efficacy of virtual reality compared with an alternative intervention or no intervention on: gait and balance activity, global motor function, cognitive function, activity limitation, participation restriction and quality of life, voxels or regions of interest identified via imaging, and adverse events. Additionally, we aimed to comment on the feasibility of virtual reality for use with stroke patients by reporting on patient eligibility criteria and recruitment.

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The Efficacy of Wii-Based Movement Therapy for Upper Limb Rehabilitation in the Chronic Poststroke Period: A Randomized Controlled Trial

Cited by 63 publications

References 15 publications

A Longitudinal Electromyography Study of Complex Movements in Poststroke Therapy. 2: Changes in Coordinated Muscle Activation

A Longitudinal Electromyography Study of Complex Movements in Poststroke Therapy. 2: Changes in Coordinated Muscle Activation

Effects of newly developed compact robot-aided upper extremity training system (Neuro-X®) in patients with stroke: A pilot study

Virtual reality for stroke rehabilitation

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