Transfer of Learning from a Virtual Table Tennis Game to Drinking from a Glass Task in Stroke Patients

Abstract

Background: Given that stroke is the cause of several neurological impairments, it is necessary to evaluate interventions that can improve patients' motor performance and functionality. Objectives: This study aimed to evaluate the motor learning transfer of a training program using a virtual table tennis game. We hypothesized that playing the virtual game may improve the performance of stroke patients in a functional activity (drinking from a glass). Moreover, this virtual reality training may have different effects according to the brain injury side. Methods: A non-randomized controlled study was performed. Sampling was by convenience. Evaluation and revaluation of a drinking from a glass task were conducted through kinematic analysis (transfer test). The training was carried out with XBOX 360 table tennis game (20 attempts). Performance (number of hits) in the game and average angular velocity of the drinking task were analyzed by ANOVA. Results: The study included 20 hemiparesis patients (10 left), mean age 50.6 (SD 9.2) years, and 20 healthy individuals, mean age 50.9 (SD 8.8) years. Patients showed worse performance than healthy subjects; however, they improved performance between the first and last attempts (P = 0.001). In the transfer test, left hemiparetic patients exhibited significant improvement in the shoulder (P = 0.0001) and elbow average angular velocity (P = 0.0001), but this did not occur in right hemiparetic patients (shoulder: P = 0.761; elbow: P = 0.666). Conclusions: The results suggest that the virtual game has clinical potential in the motor learning transfer process to a functional activity in the real world, mainly for patients with right brain injury.