Tele-rehabilitation in the Home With Gaming as a Method of Improving Upper Extremity Function After Stroke

Tele-rehabilitation in the Home With Gaming as a Method of Improving Upper Extremity Function After Stroke

The purpose of the study is to determine whether a novel computer gaming hand exercise regimen would improve hand and arm function and be feasible in people with hemiplegia after Stroke affecting the hand.

A novel computer gaming hand exercise regimen has been designed for people with hemiplegia after Stroke affecting the hand. The design allows a broad range of common objects of daily life to be seamlessly transformed into 'therapeutic' input devices by instrumenting with a small motion sense mouse. Based on individual abilities and treatment needs, objects are selected to train specific fine/ gross dexterous functions. The object manipulations (therapeutic exercises) are then used to control and play any commercially available computer game, making practice challenging and engaging.

The study is of twelve weeks duration comparing the computer gaming and conventional hand exercises in ten people with hemiplegia after Stroke affecting the hand. The investigators hypothesize that the game based exercises will improve hand function and will be feasible. A mixed-effect repeated measures analysis of variance will be conducted to test pre to post treatment outcomes.

Inclusion Criteria:

• Time since stroke onset less than 1 year.
• Ability to actively extend at least 10 degrees at the Metacarpophalangeal and Interphalangeal joints and 10 degrees at the wrist. At least 30 degree of active flexion-extension at elbow and some active movements present at the shoulder joint.
• English speaking.
• No clinical evidence of cognitive impairment (screened by physician or therapist).
• Have a personal computer at home.
• Lives in Winnipeg.
• Able to provide informed consent.

Exclusion Criteria:

• Patients having excessive spasticity, pain or contractures in the more affected limb will not be included in the study.
• Convulsive seizures preventing adequate attention to task.
• Problem with vision.
• Aphasia.
• Apraxia.