Multicentre pilot randomised control trial of a self-directed exergaming intervention for poststroke upper limb...

Area of Science:

• Neurorehabilitation
• Digital Health
• Stroke Recovery

Background:

• Conventional stroke rehabilitation often focuses on supervised therapy.
• Technology-facilitated, self-directed interventions offer a potential adjunct to enhance upper limb recovery.
• There is a need to assess patient engagement and adherence to such interventions.

Purpose of the Study:

• To assess stroke survivor engagement in self-directed upper limb (UL) training using exergaming.
• To explore factors influencing adherence to a technology-facilitated rehabilitation program.
• To evaluate the study design for a definitive randomized controlled trial (RCT) on UL recovery post-stroke.

Main Methods:

• A multicentre, internal pilot randomized controlled trial (RCT) with nested qualitative methods.
• Stroke survivors with UL paresis received training on an exergaming device for 3 months of self-directed rehabilitation.
• Primary outcome: Fugl Meyer Upper Extremity Assessment (FM-UE) at 6 months; secondary outcomes included ARAT, Barthel Index, and modified Rankin Scale. Qualitative interviews explored adoption factors.

Main Results:

• The study is designed to collect data for power calculations for a definitive RCT.
• Qualitative data will identify themes related to intervention adoption and adherence.
• The pilot aims to establish feasibility and inform the design of a larger efficacy trial.

Conclusions:

• Self-directed, technology-facilitated upper limb rehabilitation warrants further investigation as an adjunct to conventional stroke care.
• Understanding patient engagement and adherence is crucial for successful implementation.
• This pilot study provides a foundation for a definitive RCT to test the efficacy of exergaming for post-stroke UL recovery.