Exergame-Based Upper-Limb Rehabilitation in Adults With Chronic Stroke

A Randomized Controlled Trial Assessing the Efficacy, Feasibility, and Usability of an Exergame-Based Semi-Autonomous Upper-Limb Rehabilitation Program in Individuals With Chronic Stroke

This study is a randomized controlled trial designed to evaluate the effectiveness of a semi-autonomous upper-limb rehabilitation program based on exergames in adults with chronic stroke. Participants will be randomly assigned (1:1) to either an exergame-based intervention or an individually delivered conventional home-based therapy program. The primary outcome is upper-limb functionality as measured by the Action Research Arm Test (ARAT). Secondary outcomes include upper-limb motor function and quality of life. The study also examines adherence, usability, and the feasibility of remote monitoring for long-term implementation.

Inclusion Criteria:

• Adults aged 18 years or older.
• Confirmed diagnosis of chronic stroke with more than 6 months of evolution.
• Ability to maintain independent sitting and standing (with or without assistive devices).
• Upper-limb functional capacity ranging from limited to moderate, defined as an ARAT score between 11 and 54 points.
• Ability to understand and follow simple instructions (Mini-Mental State Examination ≥ 23).
• Ability to provide informed consent personally or through a legal representative.

Exclusion Criteria:

• Acute illness, musculoskeletal pathology, or pain that interferes with the performance of rehabilitation exercises.
• Uncompensated sensory deficits, including significant visual or hearing impairments.
• Disruptive behavior or neuropsychiatric conditions that may limit participation.
• Active epilepsy or any medical contraindication to physical exercise.
• Botulinum toxin treatment affecting the upper limb within the previous 6 months.