Self-Directed Exergaming for Stroke Upper Limb Impairment Increases Exercise Dose Compared to Standard Care

Area of Science:

• Neurorehabilitation
• Digital Health
• Stroke Recovery

Background:

• Exercise dose is a key factor influencing rehabilitation outcomes.
• Self-directed exercise technologies can potentially increase exercise dose.
• Real-world effectiveness of these technologies in unselected patient groups is not well understood.

Purpose of the Study:

• To quantify the exercise dose achieved by inpatient stroke survivors using an adapted upper limb (UL) exergaming device.
• To compare the exercise dose from the exergaming device with conventional supervised therapy.

Main Methods:

• Recruited 30 acute stroke patients with UL impairment over 4 months.
• Trained participants in using the exergaming device for unsupervised use during inpatient stay.
• Compared self-directed exergaming dose with conventional UL therapy dose.

Main Results:

• 26 out of 30 recruited patients (35%) meaningfully used the device.
• Self-directed exergaming provided 26 minutes/day of UL exercise.
• Total daily exercise duration doubled (51 min/day) and repetitions increased eightfold (104 reps/day) compared to standard care.

Conclusions:

• Adapted exergaming significantly increased exercise duration and repetitions for inpatient stroke survivors.
• Self-directed exergaming is a viable strategy to augment conventional therapy without additional supervision.
• This approach holds promise for improving stroke rehabilitation outcomes.