Effects of Video-Game Based Therapy on Balance, Postural Control, Functionality, and Quality of Life of Patients with Subacute Stroke: A Randomized Controlled Trial

Abstract

Purpose. To determine the effects of a structured protocol using commercial video games on balance, postural control, functionality, quality of life, and level of motivation in patients with subacute stroke. Methods. A randomized controlled trial was conducted. A control group (n = 25) received eight weeks of conventional rehabilitation consisting of five weekly sessions based on an approach for task-oriented motor training. The experimental group (n = 23) received conventional rehabilitation + video-game based therapy for eight weeks with commercial video games using the Xbox 360° video games console and the Kinect® device with the same total treatment time for both groups. The Modified Rankin Scale, Barthel Index, Tinetti scale, Functional Reach test, Get Up and Go test, Baropodometry, EuroQoL 5D (EQ-5D), satisfaction, adherence, and motivation were used as outcome measures. Results. In the between-group comparison, statistically significant differences were observed in the Modified Rankin scores (p<0.01), the Barthel Index (p=0.05), the Tinetti gait assessment (p=0.02), the Functional Reach test (p<0.01), the Get Up and Go test (p=0.05), the pain/discomfort dimension (p<0.01), and anxiety/depression dimension (p<0.01) of the EQ-5D and the VAS (visual analog scale) (p<0.01) on the perceived health status based on the EQ-5D questionnaire. Regarding the scale of motivation, self-esteem, and adherence, statistically significant differences were achieved in motivation (p<0.01), self-esteem (p<0.01), and adherence (p<0.01) variables. Conclusion. A protocol of semi-immersive video-game based therapy, combined with conventional therapy, may be effective for improving balance, functionality, quality of life, and motivation in patients with subacute stroke. This trial is registered with NCT03528395.