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Training by Using an Adaptive Foot Switch and Video Games to Improve Balance and Mobility Following Stroke: A Randomised Controlled Trial

Published online by Cambridge University Press:  12 October 2018

Hsieh-Chun Hsieh
Hsieh-Chun Hsieh*
Affiliation:
Department of Special Education, National Tsing Hua University, Hsinchu City, Taiwan, R.O.C.
*
Address for correspondence: Hsieh-Chun Hsieh, Department of Special Education, National Tsing Hua University, No. 521, Nanda Rd., Hsinchu City, Taiwan, R.O.C. E-mail: [email protected].
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Abstract

In this study, an altered switch for rehabilitation was invented to make home training accessible for the stroke patients, by modifying a computer mouse into a foot switch. This study examined the effects of training with an adaptive foot switch and video games (VG) on walking performance and balance abilities (Centre of Pressure (CoP) sway) in people after stroke.

The intervention was evaluated through a randomised controlled trial. The intervention group received 10 weeks of VG rehabilitation, for approximately 3.5 hours/week, using a pressure-activated electronic foot switch, in addition to standard rehabilitation. The control group received regular rehabilitation only. The experiment included a force platform (measuring CoP sway kinematics) and a 10-Metre Test of Walking (10MWT) to measure the standing balance and walking performance of 56 stroke patients.

There were no differences between the two groups (intervention and control) at baseline in terms of the demographic or dependent variables. Multivariate tests indicated a significant interaction between the Patient Group and the Time-type variables. Subsequent analysis of the main effects revealed significant between-group differences over time in all dependent variables (10MWT, sway area, CoP sway in anterior–posterior direction (AP sway) and CoP sway in medial–lateral direction (ML sway)). Patients in the intervention group demonstrated better performance than those in the control group after the VG rehabilitation according to the post-test.

This study suggests that ankle muscle training using an adaptive foot switch and VG may improve exercise compliance and enhance recovery of balance and mobility following stroke.

Keywords

Strokerandomised controlled trialwalkingstroke rehabilitationpostural balancevideo games
Type
Articles
Information
Brain Impairment , Volume 20 , Issue 1 , March 2019 , pp. 16 - 23
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2018 

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References

Asbjørn, R., & Gunnar, B.J.A. (1982). Normal range of motion of the hip, knee and ankle joints in male subjects, 30–40 years of age. Acta Orthopaedica Scandinavica, 53 (2), 205–208.Google Scholar
Bateni, H. (2012). Changes in balance in order adults based on use of physical therapy vs. the Wii Fit gaming system: A preliminary study. Physiotherapy, 98, 211–216.Google Scholar
Bowden, M., Balasubramanian, C., Behrman, A.L., & Kautz, S.A. (2008). Validation of a speed-based classification system using quantitative measures of walking performance post stroke. Neurorehabilitation and Neural Repair, 22, 672–675.Google Scholar
Brunnstrom, S. (1970). Movement therapy in Hemiplegia: A neurophysiological approach. New York: Harper & Row.Google Scholar
Carr, J.H., & Shepherd, R.B. (1989). A motor learning model for stroke rehabilitation. Physiotherapy, 75 (7), 372–380.Google Scholar
Cho, H.Y., Kim, J.S., & Lee, G.C. (2013). Effects of motor imagery training on balance and gait abilities in post-stroke patients: A randomized controlled trial. Clinic Rehabilitation, 27, 675–680.Google Scholar
Cikajlo, I., Rudolf, M., Goljar, N., Burger, H., & Matjacic, Z. (2012). Telerehabilitation using virtual reality task can improve balance in patients with stroke. Disability and Rehabilitation, 34, 13–18.Google Scholar
Corbetta, D., Imeri, F., & Gatti, R. (2015). Rehabilitation that incorporates virtual reality is more effective than standard rehabilitation for improving walking speed, balance and mobility after stroke: A systematic review. Journal of Physiotherapy, 61 (3), 117–124.Google Scholar
Deng, H., Durfee, W.K., & Nuckley, D.J. (2010). Complex versus simple ankle movement training in stroke using telerehabilitation: A randomized controlled trial. Physical Therapy, 92 (2), 197–209.Google Scholar
Girone, M., Burdea, G., & Bouzit, M. (2001). A Stewart platform-based system for ankle telerehabilitation. Autonomous Robots, 10, 203–212Google Scholar
Goljar, N., Burger, H., Rudolf, M., & Stanonik, I. (2010). Improving balance in sub acute stroke patients: A randomized controlled study. International Journal of Rehabilitaion Research, 33 (3), 205–210. doi: 10.1097/MRR.0b013e328333de61.Google Scholar
Harris, J.E., Eng, J.J., Marigold, D.S., Tokuno, C.D., & Louis, C.L. (2005). Relationship of balance and mobility to fall incidence in people with chronic stroke. Physical Therapy, 85, 150–158.Google Scholar
Hintermann, B. (2005). Total ankle arthroplasty: Historical overview, current concepts and future perspectives. New York, NY: Springer.Google Scholar
Holden, M. (2005). Virtual environments for motor rehabilitation: Review. Cyberpsychology & Behavior, 8, 187–218.Google Scholar
Hsieh, H.C., Lin, H.Y., Chiu, W.H., Meng, L.F., and Liu, C.K. (2015). Upper-limb rehabilitation with adaptive video games for preschool children with developmental disabilities. The American Journal of Occupational Therapy, 69 (4), 1–5.Google Scholar
Karnath, H.O., & Broetz, D. (2015). Understanding and treating Pusher syndrome. Physical Therapy, 83, 1119–1125.Google Scholar
Katz, N., Ring, H., Naveh, Y., Kizony, R., Feintuch, U., & Weiss, P.L. (2005). Effect of interactive virtual environment training on independent safe street crossing of stroke patients with unilateral spatial neglect. Disability and Rehabilitation, 27, 1235– 1243.Google Scholar
Kizony, R., Katz, N., & Weiss, P.L. (2004). Virtual reality based intervention in rehabilitation: Relationship between motor and cognitive abilities and performance within virtual environments for patients with stroke. In Proc. 5th Intl Conf. Disability, Oxford, UK.Google Scholar
Kristensen, H.K., Borg, T., & Hounsgaard, L. (2011). Facilitation of research-based evidence within occupational therapy in stroke rehabilitation. British Journal of Occupational Therapy, 74 (10), 473– 483.Google Scholar
Lamontagne, A., Malouin, F., Richards, C.L., & Dumas, F. (2002). Mechanisms of disturbed motor control in ankle weakness during gait after stroke. Gait & Posture, 15 (3), 244–255.Google Scholar
Laver, K.E., George, S., Thomas, S., Deutsch, J.E., & Crotty, M. (2015). Virtual reality for stroke rehabilitation. Cochrane Database Systematic Reviews, 12, CD008349.Google Scholar
Lum, P., Reinkensmeyer, D., Mahoney, R., Rymer, W. Z., & Burgar, C. (2002). Robotic devices for movement therapy after stroke: Current status and challenges to clinical acceptance. Topics in Stroke Rehabilitation, 8 (4), 40–53.Google Scholar
Mochizuki, L., Duarte, M., Amadio, A.C., Zatsiorsky, V.M., & Latash, M.L. (2006). Changes in postural sway and its fractions in conditions of postural instability. Journal of Applied Biomechanics, 22 (1), 51–60.Google Scholar
Olivetti, L., Schurr, K., Sherrington, C., Wallbank, G., Pamphlett, P., & Mun-San Kwan, M. (2007). A novel weight-bearing strengthening program during rehabilitation of older people is feasible and improves standing up more than a non-weight-bearing strengthening program: A randomized trial. Journal of Physiotherapy, 53, 147–153.Google Scholar
Peterka, R.J. (2002). Sensorimotor integration in human postural control. Journal of Neurophysiology, 88, 1097–1118.Google Scholar
Proffitt, R., Alankus, G., Kelleher, C., & Engsberg, J. (2011). Use of computer games as an intervention for stroke. Topics in Stroke Rehabilitation, 18 (4), 417–427.Google Scholar
Rocchi, L., Chiari, L., Cappello, A., & Horak, F.B. (2006). Identification of distinct characteristics of postural sway in Parkinson's disease: A feature selection procedure based on principal component analysis. Neuroscience Letters, 394 (2), 140–145.Google Scholar
Rugelj, D., & Sevsek, F. (2007). Postural sway area of elderly subjects. WSEAS Transactions on Signal Processing, 3, 213–219.Google Scholar
Saposnik, G., & Levin, M. (2011). Virtual reality in stroke rehabilitation: A meta-analysis and implications for clinicians. Stroke, 42, 1–7.Google Scholar
Schulz, K., Altman, D. G., Moher, D. for the CONSORT Group (2010). CONSORT 2010 statement: Updated guidelines for reporting parallel group randomized trials. Annals of Internal Medicine, 152 (11), 726–732.Google Scholar
Tilson, J.K., Sullivan, K.J., Cen, S.Y., Rose, D.K., Koradia, C.H., Azen, S.P., & Duncan, P.W. (2010). Meaningful gait speed improvement during the first 60 days poststroke minimal clinically important difference. Physical Therapy, 90 (2), 196–208.Google Scholar
Titianova, E.B., & Tarkka, I.M. (1995). Asymmetry in walking performance and postural sway in patients with chronic unilateral cerebral infarction. Journal of Rehabilitation Research & Development, 32 (3), 236–244.Google Scholar
Tyson, S.F., Hanley, M., Chillala, J., Selley, A., & Tallis, R.C. (2006). Balance disability after stroke. Physical Therapy, 86 (1), 30–38.Google Scholar
Tyson, S., & Connell, L. (2009). The psychometric properties and clinical utility of measures of walking and mobility in neurological conditions: A systematic review. Clinic Rehabilitation, 23 (11), 1018– 1033.Google Scholar
van Duijnhoven, H.J., Heeren, A., Peters, M.A., Veerbeek, J.M., Kwakkel, G., Geurts, A.C., & Weerdesteyn, V. (2016). Effects of exercise therapy on balance capacity in chronic stroke: Systematic review and meta-analysis. Stroke, 47 (10), 2603–2610.Google Scholar
van Meulen, F.B., Weenk, D., van Asseldonk, E.H., Schepers, H.M., Veltink, P.H., & Buurke, J.H. (2016). Analysis of balance during functional walking in stroke survivors. PLoS One, 11 (11), e0166789.Google Scholar
Viñas-Diz, S., & Sobrido-Prieto, M. (2016). Virtual reality for therapeutic purposes in stroke: A systematic review. Neurologia, 31 (4), 255–277.Google Scholar