Self-directed exergaming for stroke upper limb impairment increases exercise dose compared to standard care
Self-directed exergaming for stroke upper limb impairment increases exercise dose compared to standard care
Background. One of the strongest modifiable determinants of rehabilitation outcome is exercise dose. Technologies enabling self-directed exercise offer a pragmatic means to increase dose, but the extent to which they achieve this in unselected cohorts, under real-world constraints, is poorly understood. Objective. Here we quantify the exercise dose achieved by inpatient stroke survivors using an adapted upper limb (UL) exercise gaming (exergaming) device and compare this with conventional (supervised) therapy. Methods. Over 4 months, patients presenting with acute stroke and associated UL impairment were screened at a single stroke centre. Participants were trained in a single session and provided with the device for unsupervised use during their inpatient admission. Results. From 75 patients referred for inpatient UL therapy, we recruited 30 (40%), of whom 26 (35%) were able to use the device meaningfully with their affected UL. Over a median enrolment time of 8 days (IQR: 5–14), self-directed UL exercise duration using the device was 26 minutes per day (median; IQR: 16–31), in addition to 25 minutes daily conventional UL therapy (IQR: 12–34; same cohort plus standard care audit; joint n = 50); thereby doubling total exercise duration (51 minutes; IQR: 32–64) relative to standard care (Z = 4.0, P <.001). The device enabled 104 UL repetitions per day (IQR: 38–393), whereas conventional therapy achieved 15 UL repetitions per day (IQR: 11–23; Z = 4.3, P <.001). Conclusion. Self-directed adapted exergaming enabled participants in our stroke inpatient cohort to increase exercise duration 2-fold, and repetitions 8-fold, compared to standard care, without requiring additional professional supervision.
exercise gaming, physiotherapy, rehabilitation, rehabilitation technology, stroke, upper limb
974-985
Broderick, Michelle
d21ad550-9496-4117-aa0e-83b1f915a9f5
Almedom, Leeza
599f7ae3-b434-4bd9-a027-2f0ef7a054e0
Burdet, Etienne
963b1ab0-1d8a-48a5-b5da-a189d13e88f6
Burridge, Jane
0110e9ea-0884-4982-a003-cb6307f38f64
Bentley, Paul
d352c6e3-8ca7-4296-ad8b-c475a3cc4da7
1 November 2021
Broderick, Michelle
d21ad550-9496-4117-aa0e-83b1f915a9f5
Almedom, Leeza
599f7ae3-b434-4bd9-a027-2f0ef7a054e0
Burdet, Etienne
963b1ab0-1d8a-48a5-b5da-a189d13e88f6
Burridge, Jane
0110e9ea-0884-4982-a003-cb6307f38f64
Bentley, Paul
d352c6e3-8ca7-4296-ad8b-c475a3cc4da7
Broderick, Michelle, Almedom, Leeza, Burdet, Etienne, Burridge, Jane and Bentley, Paul
(2021)
Self-directed exergaming for stroke upper limb impairment increases exercise dose compared to standard care.
Neurorehabilitation and Neural Repair, 35 (11), .
(doi:10.1177/15459683211041313).
Abstract
Background. One of the strongest modifiable determinants of rehabilitation outcome is exercise dose. Technologies enabling self-directed exercise offer a pragmatic means to increase dose, but the extent to which they achieve this in unselected cohorts, under real-world constraints, is poorly understood. Objective. Here we quantify the exercise dose achieved by inpatient stroke survivors using an adapted upper limb (UL) exercise gaming (exergaming) device and compare this with conventional (supervised) therapy. Methods. Over 4 months, patients presenting with acute stroke and associated UL impairment were screened at a single stroke centre. Participants were trained in a single session and provided with the device for unsupervised use during their inpatient admission. Results. From 75 patients referred for inpatient UL therapy, we recruited 30 (40%), of whom 26 (35%) were able to use the device meaningfully with their affected UL. Over a median enrolment time of 8 days (IQR: 5–14), self-directed UL exercise duration using the device was 26 minutes per day (median; IQR: 16–31), in addition to 25 minutes daily conventional UL therapy (IQR: 12–34; same cohort plus standard care audit; joint n = 50); thereby doubling total exercise duration (51 minutes; IQR: 32–64) relative to standard care (Z = 4.0, P <.001). The device enabled 104 UL repetitions per day (IQR: 38–393), whereas conventional therapy achieved 15 UL repetitions per day (IQR: 11–23; Z = 4.3, P <.001). Conclusion. Self-directed adapted exergaming enabled participants in our stroke inpatient cohort to increase exercise duration 2-fold, and repetitions 8-fold, compared to standard care, without requiring additional professional supervision.
Text
Self-directed exergaming for stroke upper-limb impairment increases exercise dose compared to standard care-proof
- Accepted Manuscript
More information
e-pub ahead of print date: 27 August 2021
Published date: 1 November 2021
Additional Information:
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study was funded by NIHR i4i award II-LA-1117-20 008 and Imperial College NIHR Biomedical Research Centre.
Keywords:
exercise gaming, physiotherapy, rehabilitation, rehabilitation technology, stroke, upper limb
Identifiers
Local EPrints ID: 453387
URI: http://eprints.soton.ac.uk/id/eprint/453387
ISSN: 1545-9683
PURE UUID: 05e4d742-431d-4a19-bd45-b3f21d9dc240
Catalogue record
Date deposited: 13 Jan 2022 18:19
Last modified: 04 Jun 2024 01:35
Export record
Altmetrics
Contributors
Author:
Michelle Broderick
Author:
Leeza Almedom
Author:
Etienne Burdet
Author:
Paul Bentley
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics
