Comparing the Cognitive Effects of Two Exergame Training and Traditional Training in Patients With Chronic Stroke
- Conditions
- Stroke
- Interventions
- Device: Wii Fit(30 Mins)Other: Conventional weight-shifting(30 Mins)Device: Tetrax biofeedback(30 Mins)
- Registration Number
- NCT02553993
- Lead Sponsor
- Chang Gung Memorial Hospital
- Brief Summary
The objective of this study was to: compare the training and maintenance effects of 3 balance training programs (2 kinds of exergame systems and 1 conventional weight-shifting training program) on cognitive function of subjects with chronic stroke.
- Detailed Description
The objective of this study was to: compare the training and maintenance effects of 3 balance training programs (2 kinds of exergame systems and 1 conventional weight-shifting training program) on cognitive function of subjects with chronic stroke. We hypothesized that the exergaming program using weight shifting as game controller is better than the weight shifting only program. The investigators further hypothesized that exergames designed for entertainment (such as Wii Fit) are more beneficial than exergames for rehabilitation purpose (such as Tetrax biofeedback) in gain of cognition function for patients with chronic stroke.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 43
- Post-stroke duration of at least 6 months
- Ability to understand verbal instructions and learn
- Adequate visual acuity (with appropriate correction, if necessary)
- Ability to walk independently with or without device
- Bilateral hemispheric
- Cerebellar lesions
- Aphasia
- Significant visual field deficits
- Hemineglect
- History of orthopedic
- Other neurological diseases
- Medical conditions that would prevent adherence to the exercise protocol
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Wii Fit Wii Fit(30 Mins) The Wii Fit training was conducted using the Wii Fit bundle from Nintendo, which consists of the Wii console, a Wii Balance Board, and the Wii Fit Plus balance game disc. The Wii balance board has 4 transducers, which could assess the player's force distribution and resultant movements in the center of pressure (COP). The participants stood on the board and used the change of COP to play the games. Five games (Tilt, Soccer Heading, Balance Bubble, Penguin Slide, and Perfect 10) were selected from the Wii Fit Plus package based on the motor demand of these games. The major movement patterns to play the games included right-left weight shifting and front-back weight shifting. Conventional weight-shifting Conventional weight-shifting(30 Mins) The conventional weight-shifting exercise group performed balance exercises with the similar movements and time required by the 2 exergame systems but without video games. By using occupational activities, participants did weight shifting in the sagittal and frontal planes. The investigators also used a balance board (Reebok Core board) for multi-directional weight shifting training Tetrax biofeedback Tetrax biofeedback(30 Mins) The Tetrax biofeedback games aimed at postural rehabilitation to help patients or athletes improve their balance abilities. There were 11 games in Tetrax system; 8 games (Speedtrack, Catch, Skyball, Gotcha, Speedball, Tag, Freeze, Immobilizer) were chosen based on the same principle as those used for choosing Wii Fit games. The parameters of games' difficulties included target size and/or speed of target movement, which could be adjusted according to the patients' ability. For the Wii Fit or Tetrax group, at each session, the supervising therapist chose 3 to 5 games for participants according to their ability, needs, and favorites.
- Primary Outcome Measures
Name Time Method Change from Baseline in Cognitive Abilities Screening Instrument Scale Chinese version (CASI C-2.0) Subjects will be assesed at 12 weeks and 24 weeks The CASI C-2.0 consists of 20 item sets, which can be divided into 9 domains, including long-term memory, short-term memory, attention, concentration or mental manipulation, orientation, abstraction/judgment, language, visual construction, and category fluency. The CASI scores range from 0 to 100, with higher scores indicating better cognitive performance.
- Secondary Outcome Measures
Name Time Method Change from Baseline in The Stroop test Subjects will be assesed at 12 weeks and 24 weeks The Stroop test requires selective attention, response inhibition, and working memory. The Stroop score ranges from 0 to 63, with higher scores indicating better performance.
Change from Baseline in The modified Trail Making Test(TMT) Subjects will be assesed at 12 weeks and 24 weeks The modified Trail Making Test (TMT) requires visual scanning, visuo-motor tracking, divided attention, and cognitive flexibility. The shorter time to complete the test means better performance.
Change from Baseline in Tetrax balance system Subjects will be assesed at 12 weeks and 24 weeks Tetrax balance system will be used to assess static standing balance. The lower risk scores is indicating better performance.
Change from Baseline in Timed Up and Go (TUG) test Subjects will be assesed at 12 weeks and 24 weeks Timed Up and Go (TUG) test will be used to assessed Dynamic balance function. The shorter time it take means better performance.
Change from Baseline in The 10m walking test Subjects will be assesed at 12 weeks and 24 weeks The 10m WT is a reliable, valid, and responsive measure for sub-acute stroke. Walking speed will be assessed by self-selected gait speed over 10 m. The shorter time it takes is indicating better performance.
Change from Baseline in Stroke Impact Scale Subjects will be assesed at 12 weeks and 24 weeks The Stroke Impact Scale (SIS) is a 59-item self-reported scale with good reliability, validity, and sensitivity to change. The SIS consists of 8 functional domains: strength, memory, emotion, communication, ADL/ instrumental ADL (IADL), mobility, hand function, and participation. The overall SIS score represents the average score of the 8 domains. Each item score ranges from 1 to 5. Each domain score has a range of 0 to 100 and is computed by using the following equation: Score =\[(Mean - 1)/(5 - 1)\] × 100. In this equation, the score is that of a particular domain, and the mean is the average of the item scores within that domain. A higher score on an item denotes better performance.
Change from Baseline in The digit backward performance Subjects will be assesed at 12 weeks and 24 weeks The digit backward performance requires attention and working memory. The scores range from 2 to 7 higher scores indicating better performance.
Change from Baseline in Physiological profile assessment(PPA) Subjects will be assesed at 12 weeks and 24 weeks The PPA is a validated battery of sensorimotor measurements used to identify those subjects at risk of falling.
Change from Baseline in The Frenchay Activities Index (FAI) Subjects will be assesed at 12 weeks and 24 weeks The Frenchay Activities Index (FAI) was used as a measure of subjects' participation level. The 15-item index records the frequency of performing social activities as well as more complex activities of daily living (eg, domestic chores, outdoor mobility, leisure, gainful work). The FAI item score is based on the frequency with which an activity was performed, and ranges from 0 (low frequency) to 3 (high frequency). Ten items concern the past 3 months and 5 items concern the past 6 months. The FAI total score is the sum of item scores, and ranges from 0 (inactive) to 45 (highly active).
Change from Baseline in Physical Activity Enjoyment Scale (PACES) Subjects will be assesed at 12 weeks and 24 weeks The PACES is a 18-item and 7-point self-reported scale, and the higher score has more enjoyment of the training.
Trial Locations
- Locations (1)
Department of Rehabilitation, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan
🇨🇳Kaohsiung, Taiwan