Effects and perception of intensive exergaming training on upper limb functions after stroke: mixed method study

Objective To determine the effects and perception of intensive exergaming training on upper limb motor functions in subacute stroke patients.Methods This one-year interventional mixed-methods study was conducted at Pakistan Railway General Hospital, Rawalpindi, using a sequential quantitative–qualitative design. In the quantitative phase, 42 participants were recruited and randomly allocated to two groups – experimental (n = 21) and control (n = 21). The experimental group received Xbox 360 Kinect-based exergaming, in conjunction with task-oriented training five sessions per week for 6 weeks. For the qualitative study, 15 patients from the experimental group were included. Primary outcome measures for upper-limb function were the Fugl-Meyer Assessment upper limb (FMUE) and the Chedoke Arm and Hand Inventory-13. Secondary outcome measures included the Subjective Index of Physical and Social Outcome (SIPSO), the Fatigue Severity Scale (FSS), and the Visual Analogue Scale (VAS). The treatment duration for both groups spanned 6 weeks, with 1-hour sessions (30 minutes for exergaming and 30 minutes for task-oriented training) 5 times a week.Results After intervention experimental group had better results in all analyzed variables (shoulder, elbow, and forearm; wrist and hand) than the control group for FMUE (p < .01), Chedoke Arm & hand inventory (p < .01), FSS (p < .01), SIPSO (p < .01), and VAS (p < .01), suggesting that exergaming training combined with task-oriented training is more effective than task-oriented training alone. Patients’ perception regarding gaming showed overall satisfactory improvement.Conclusion The combination of exergaming and task-oriented training was effective for stroke patients. The participants’ experiences were satisfactory, fun, and challenging, as they included visual and auditory feedback.Clinical Trial number: NCT05315089