A recent trial has found a specific type of video-game therapy is as effective as traditional methods of rehabilitation in patients recovering from a stroke. The trial also found the novel therapy reduces the need for face-to-face time with occupational therapists by 80 percent.
Rehabilitation from stroke often involves a combination of behavioral and motor interventions requiring significant in-person contact with occupational therapists. The most time consuming part of a patient’s time with a therapist often involves what is known as Constraint-Induced Movement Therapy (CI therapy), which involves working closely with a physical therapist to improve function in the upper limbs.
"As an occupational therapist, I have seen patients from rural areas drive more than an hour to come to an in-person clinic three to four days a week, where the rehab is very intensive, taking three to four hours per session, and the therapist must be there the whole time," explained Rachel Proffitt, a researcher working on the new study.
Using video games as a form of physical therapy is not a new idea but this research set out to robustly compare the efficacy of video game therapy compared to face-to-face CI therapy. More than one hundred subjects were recruited for the trial. Each subject was more than six months past a stroke and suffering chronic mild to moderate upper limb limitations.
The researchers used a video game called Recovery Rapids, which was developed several years ago to directly target the same upper limb motion focused on by physical therapists in CI therapy.
"The patient is virtually placed in a kayak, and as they go down the river, they perform arm motions simulating paddling, rowing, scooping up trash, swaying from side to side to steer, and reaching overhead to clear out spider webs and bats, so it's making the exercises fun," said Proffitt. "As they progress, the challenges get harder, and we conduct check-ins with the participants via telehealth to adjust goals, provide feedback and discuss the daily activities they want to resume as they improve."
The trial ultimately found patients experienced similar success with the video game protocol to those patients in the CI therapy control group. Not only did the novel video-game-based therapeutic program eliminate the need for patients to travel to see therapists several times a week, but it meant the remaining behavioral therapy interventions could effectively be conducted via remote telehealth.
This led to similar successful therapeutic outcomes using just one-fifth of the therapists time required by intensive CI therapy. Proffitt said this saves time, money, makes it easier for patients to complete therapy and allows therapists to work with greater numbers of patients.
"With this new at-home gaming approach, we are cutting costs for the patient and reducing time for the therapist while still improving convenience and overall health outcomes, so it's a win-win,” said Proffitt. “By saving time for the therapists, we can also now serve more patients and make a broader impact on our communities."
The new study was published in the journal eClinicalMedicine.
Source: University of Missouri
