Active Video Games Help Stroke Survivors Regain Arm Strength in Study
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Reviewed By Louise Chang, MD
Feb. 25, 2010 (San Antonio) -- Active Wii video games may bring some fun into stroke recovery, helping patients regain lost strength and motor skills in the process.
In a first-of-its-kind study, 11 stroke victims with weakness in their arms could reach out and grab objects more easily and more quickly after two weeks of playing the active video games.
In contrast, 11 stroke patients who played card or block games for two weeks showed no change in arm strength afterward, says Gustavo Saposnik, MD, director of the Stroke Outcomes Research Unit at St. Michael's Hospital in Toronto.
"For the first time, we've shown that the virtual reality gaming system is safe, feasible, and potentially effective at improving motor function after stroke," he tells WebMD.
Until the video games prove safe in larger numbers of stroke survivors -- shoulder pain being the main concern -- it's too soon to recommend people start playing Wii games after stroke, Saposnik says.
But should the video games pan out in a study of 120 stroke patients now in the planning stage, the Canadian researchers believe they will become an adjunct to traditional stroke rehab programs.
"The great thing about gaming is that it engages the patient and motivates them to participate -- for hours. It gets them to use the [weak] arm repeatedly, which is what is needed to regain strength. And it's fun," says American Stroke Association spokeswoman Pamela Duncan, PhD, a physical therapist at Duke University in Durham, N.C. Duncan is familiar, but not involved, with the research.
Stroke Rehab With Wii Games
Saposnik says he got the idea for the study after his 5-year-old daughter told him their Wii tennis match was stacked against her.
To even out the odds, the left-handed researcher tried playing with his right hand. "It was difficult. But over time, I got better, leading me to believe [the games] could be beneficial for stroke rehabilitation," he says.
The study involved 22 people whose strokes left one arm weak, although they were able to touch their chin or opposite knee.
Two months after their stroke, half began a two-week course of video game therapy with Wii tennis and Wii Cooking Mama, which uses movements that simulate cutting a potato, peeling an onion, slicing meat, and shredding cheese.
The patients could use a Velcro strap to attach the controller to their hand if necessary.
The others played recreational card games or Jenga, a block stacking and balancing game.
Both groups engaged in eight doctor-supervised sessions, about an hour long, over a two-week period. "During each session, they'd engage in one game for 30 minutes, then the other for the next 30 minutes," Saposnik says.
The findings were presented here at the American Stroke Association's International Stroke Conference 2010.
Improved Speed and Strength
None of the participants experienced any serious side effects from the games. Two patients in the recreational therapy group and three patients in the Wii group reported being unusually tired after the sessions.
When evaluated after the two-week course of therapy and again a month later, people in the Wii group could reach out and grab an object such as a can of soda about seven seconds more quickly than those who played recreational games, Saposnik says.
"That may not seem like much, but if you imagine every task you do being seven seconds longer than usual, you'll see how quickly it adds up over the course of a day," he says.
People in the video game group also had a stronger grip than those in the recreational game group, he says. "They were faster and stronger," Saposnik says.
Duncan tells WebMD that the reason video games enhance motor function so much is that they are "highly repetitive and task-specific. Doing the same, precise thing over and over activates brain cells. The brain rewires and existing connections work better," she says.
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Gustavo Saposnik, MD, director Stroke Outcomes Research Unit, Li Ka Shing Institute, St. Michael's Hospital, Toronto.
Pamela Duncan, PhD, PT, spokeswoman, American Stroke Association; professor, Bette Busch Maniscalico Research Fellow, division of physical therapy, department of community and family medicine; senior fellow, Duke Center for Clinical Health Policy Research, Duke University, Durham, N.C.
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