Comparative Effects of Exergaming and Treadmill Training on Balance and Mobility in Patients with Chronic Stroke

Authors

  • Sidra Wahid Department of Physiotherapy, Central Park Medical College, Lahore, Pakistan
  • Idrees Ahmed Zahoor Central Park Medical College of Allied Health Sciences, and Teaching Hospital, Lahore, Pakistan
  • Sajid Mehmood Physical Therapy Department University of Health Sciences, Lahore, Pakistan
  • Arif Ali Rana Central Park Medical College of Allied Health Sciences, and Teaching Hospital, Lahore, Pakistan
  • Noman Ghaffar Awan Central Park Medical College of Allied Health Sciences, and Teaching Hospital, Lahore, Pakistan
  • Ali Raza Central Park Medical College of Allied Health Sciences, and Teaching Hospital, Lahore, Pakistan

DOI:

https://doi.org/10.54393/tt.v2i1.10

Keywords:

Pressure ulcers, geriatrics, bed ridden

Abstract

 Stroke is the chief cause of death and disability in the world that led toward impaired balance and mobility. Treatments that provide feedback, increase practice with multiple repetitions, and motivate patients are essential for rehabilitation after stroke. Objective: To determine whether playing video gaming exercises or treadmill training is better for balance and mobility post-stroke. Methods: A total of sixteen chronic stroke patients were randomly allocated to either the gaming or control groups. In this group patients were given visual feedback that was displayed on the screen. Participants played games for six weeks, work for 40 minutes per day, three days per week the therapy consisted solely of standing-up gameplay with no baseline therapy.  The control group training with baseline treatment for six weeks, work for 40 minutes per day, three days per week. Both groups were tested earlier the study following intervention later 6 weeks. The Berg Balance Scale and TUG were used as outcome measures (Timed Up and Go test). Results: No statistically significant difference was found between the groups when analyzed post-treatment, but some significant differences were found within the group. By assuming equal variances and degree of freedom 14, there was no statistically significant difference, the p-value for BBS before VR was .170, and after VR was.686. However, the p-value for BBS before TT was .830, and after TT was .731. For TUG p-value before VR was .264   and after VR was .571. the p-Value for TUG before TT was .908 and after .416. The difference of mean for BBS before VR was .250 and after VR was 1.250 compared before TT 1.00000 and after 2.2500. For TUG, before VR was -1.000 and after VR was -2.250 comparing TUG pre-TT was -.62500 and post TT was -.3750. Conclusion: Although there was no statistical distinction between the two categories, the gamers were more excited and driven to be involved in the intervention for a longer period of time. Before considerable gains in commercially available general-purpose games may be realized, therapist guidance in developing more optimal movement choices may be required.

References

Campbell BC, De Silva DA, Macleod MR, Coutts SB, Schwamm LH, et al. Ischaemic stroke. Nature Reviews Disease Primers. 2019,5(1):1-22. doi.org/10.1038/s41572-019-0118-8

Oladiran O, Nwosu I. Stroke risk stratification in atrial fibrillation: a review of common risk factors. Journal of community hospital internal medicine perspectives. 2019,9(2):113-20. doi.org/10.1080/20009666.2019.1593781

Patlolla SH, Lee H-C, Noseworthy PA, Wysokinski WE, Hodge DO, et al. Impact of diabetes mellitus on stroke and survival in patients with atrial fibrillation. The American Journal of Cardiology. 2020,131:33-9. doi.org/10.1016/j.amjcard.2020.06.049

Alharbi AS, Alhayan MS, Alnami SK, Traad RS, Aldawsari MA, et al. Epidemiology and Risk Factors of Stroke. Archives of Pharmacy Practice. 2019,10(4).

Kalani MYS, Alsop E, Meechoovet B, Beecroft T, Agrawal K, et al. Extracellular microRNAs in blood differentiate between ischaemic and hemorrhagic stroke subtypes. Journal of extracellular vesicles. 2020,9(1): doi.org/10.1080/20013078.2020.1713540

Kanjanahattakij N, Horn B, Abdulhadi B, Wongjarupong N, Mezue K, et al. Blood stream infection is associated with a cerebrovascular accident in patients with left ventricular assist device: a systematic review and meta-analysis. Journal of Artificial Organs. 2018,21(3):271-7. doi.org/10.1007/s10047-018-1034-5

Kim JS, Lee E-J, Chang D-I, Park J-H, Ahn SH, et al. Efficacy of early administration of escitalopram on depressive and emotional symptoms and neurological dysfunction after stroke: a multicentre, double-blind, randomised, placebo-controlled study. The Lancet Psychiatry. 2017,4(1):33-41. doi.org/10.1016/S2215-0366(16)30417-5

Malik ANM, Zafar A. High level activity training through virtual reality in chronic stroke survivor: A case report. International Journal of Rehabilitation Sciences (IJRS). 2017,4(02):36-9.

Fishbein P, Hutzler Y, Ratmansky M, Treger I, Dunsky A. A Preliminary Study of Dual-Task Training Using Virtual Reality: Influence on Walking and Balance in Chronic Poststroke Survivors. Journal of Stroke and Cerebrovascular Diseases. 2019,28(11):doi.org/10.1016/j.jstrokecerebrovasdis.2019.104343

Törnbom K, Danielsson A. Experiences of treadmill walking with non-immersive virtual reality after stroke or acquired brain injury–A qualitative study. PloS one. 2018,13(12): doi.org/10.1371/journal.pone.0209214

Munari D, Pedrinolla A, Smania N, Picelli A, Gandolfi M, et al. High-intensity treadmill training improves gait ability, VO2peak and cost of walking in stroke survivors: preliminary results of a pilot randomized controlled trial. Eur J Phys Rehabil Med. 2016,54(3):408-18.doi.org/10.23736/S1973-9087.16.04224-6

In T, Lee K, Song C. Virtual reality reflection therapy improves balance and gait in patients with chronic stroke: randomized controlled trials. Medical science monitor: international medical journal of experimental and clinical research. 2016,22:4046.doi.org/10.12659/MSM.898157

Givon Schaham N, Zeilig G, Weingarden H, Rand D. Game analysis and clinical use of the Xbox-Kinect for stroke rehabilitation. International Journal of Rehabilitation Research. 2018,41(4):323-30. doi.org/10.1097/MRR.0000000000000302

Aramaki AL, Sampaio RF, Reis ACS, Cavalcanti A. Virtual reality in the rehabilitation of patients with stroke: an integrative review. Arquivos de neuro-psiquiatria. 2019,77:268-78. doi.org/10.1590/0004-282x20190025

Park D-S, Lee D-G, Lee K, Lee G. Effects of virtual reality training using Xbox Kinect on motor function in stroke survivors: a preliminary study. Journal of Stroke and Cerebrovascular Diseases. 2017,26(10):2313-9. doi.org/10.1016/j.jstrokecerebrovasdis.2017.05.019

Cruz-Neira C, Fernández M, Portalés C. Virtual reality and games. Multidisciplinary Digital Publishing Institute; 2018. doi.org/10.3390/mti2010008

Lin AJ, Chen CB, Cheng FF, editors. Virtual Reality Games for Health Care. MATEC Web of Conferences; 2018: EDP Sciences. doi.org/10.1051/matecconf/201823201047

Lee HC, Huang CL, Ho SH, Sung WH. The effect of a virtual reality game intervention on balance for patients with stroke: a randomized controlled trial. Games for health journal. 2017,6(5):303-11. doi.org/10.1089/g4h.2016.0109

Ravenek KE, Wolfe DL, Hitzig SL. A scoping review of video gaming in rehabilitation. Disability and Rehabilitation: Assistive technology. 2016,11(6):445-53.

Liao Ww, McCombe Waller S, Whitall J. Kinect-based individualized upper extremity rehabilitation is effective and feasible for individuals with stroke using a transition from clinic to home protocol. Cogent Medicine. 2018,5(1): doi.org/10.1080/2331205X.2018.1428038

Lohse KR, Boyd LA, Hodges NJ. Engaging environments enhance motor skill learning in a computer gaming task. Journal of motor behavior. 2016,48(2):172-82. doi.org/10.1080/00222895.2015.1068158

Mao YR, Lo WL, Lin Q, Li L, Xiao X, et al. The effect of body weight support treadmill training on gait recovery, proximal lower limb motor pattern, and balance in patients with subacute stroke. BioMed research international. 2015.doi.org/10.1155/2015/175719

Gama GL, Celestino ML, Barela JA, Forrester L, et al. Effects of gait training with body weight support on a treadmill versus overground in individuals with stroke. Archives of physical medicine and rehabilitation. 2017,98(4):738-45. doi.org/10.1016/j.apmr.2016.11.022

Park J, Kim TH. The effects of balance and gait function on quality of life of stroke patients. NeuroRehabilitation. 2019,44(1):37-41. doi.org/10.3233/NRE-182467

Mainka S, Wissel J, Völler H, Evers S. The use of rhythmic auditory stimulation to optimize treadmill training for stroke patients: a randomized controlled trial. Frontiers in neurology. 2018,(9):755.doi.org/10.3389/fneur.2018.00755

De Keersmaecker E, Lefeber N, Serrien B, Jansen B, Rodriguez-Guerrero C, et al. The effect of optic flow speed on active participation during robot-assisted treadmill walking in healthy adults. IEEE Transactions on Neural Systems and Rehabilitation Engineering. 2019,28(1):221-7.doi.org/10.1109/TNSRE.2019.2955804

Tally Z, Boetefuer L, Kauk C, Perez G, Schrand L, et al. The efficacy of treadmill training on balance dysfunction in individuals with chronic stroke: a systematic review. Topics in stroke rehabilitation. 2017,24(7):539-46. doi.org/10.1080/10749357.2017.1345445

Atlas SJ, Keller RB, Chang Y, Deyo RA, Singer DE. Surgical and nonsurgical management of sciatica secondary to a lumbar disc herniation: five-year outcomes from the Maine Lumbar Spine Study. Spine. 2001,26(10):1179-87. doi.org/10.1097/00007632-200105150-00017

Downs S, Marquez J, Chiarelli P. The Berg Balance Scale has high intra-and inter-rater reliability but absolute reliability varies across the scale: a systematic review. Journal of physiotherapy. 2013,59(2):93-9. doi.org/10.1016/S1836-9553(13)70161-9

Sahin F, Yilmaz F, Ozmaden A, Kotevoglu N, Sahin T, et al. Reliability and validity of the Turkish version of the Berg Balance Scale. Journal of Geriatric Physical Therapy. 2008,31(1):32-7.doi.org/10.1519/00139143-200831010-00006

Bohannon RW. Reference values for the timed up and go test: a descriptive meta-analysis. Journal of geriatric physical therapy. 2006,29(2):64-8. doi.org/10.1519/00139143-200608000-00004

Graham SA, Roth EJ, Brown DA. Walking and balance outcomes for stroke survivors: a randomized clinical trial comparing body-weight-supported treadmill training with versus without challenging mobility skills. Journal of NeuroEngineering and Rehabilitation. 2018,15(1):92. doi.org/10.1186/s12984-018-0442-3

Lee HS, Park YJ, Park SW. The effects of virtual reality training on function in chronic stroke patients: a systematic review and meta-analysis. BioMed research international. 2019. doi.org/10.1155/2019/7595639

Mustafaoğlu R, Erhan B, Yeldan İ, Hüseyinsinoğlu BE, Gündüz B, et al.The effects of body weight-supported treadmill training on static and dynamic balance in stroke patients: A pilot, single-blind, randomized trial. Turkish Journal of physical medicine and rehabilitation. 2018,64(4):344.doi.org/10.5606/tftrd.2018.2672

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Published

2021-06-30
CITATION
DOI: 10.54393/tt.v2i1.10
Published: 2021-06-30

How to Cite

Wahid, S., Zahoor, I. A. ., Mehmood, S., Rana, A. A., Awan, N. G., & Raza, A. (2021). Comparative Effects of Exergaming and Treadmill Training on Balance and Mobility in Patients with Chronic Stroke. THE THERAPIST (Journal of Therapies &Amp; Rehabilitation Sciences), 2(1), 23–31. https://doi.org/10.54393/tt.v2i1.10

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