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Updated: Apr 30, 2026

Mobile Game-based Virtual Reality Program for Upper Extremity Stroke Rehabilitation
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Rehabilitation Your Way: A Randomized Trial Comparing 2 Home-Based and Self-Managed Programs After Stroke.

Kelly P Westlake1, Sandy McCombe Waller1,2, Laurence Magder3

  • 1Department of Physical Therapy and Rehabilitation Science University of Maryland School of Medicine Baltimore MD USA.

Journal of the American Heart Association
|September 25, 2025
PubMed
Summary
This summary is machine-generated.

Home-based stroke rehabilitation using the STRONG online program showed similar motor gains to a paper-based program but improved daily arm and hand function and adherence. This approach may benefit stroke survivors seeking accessible rehabilitation options.

Keywords:
home‐basedrehabilitationself‐managedstrokeupper extremity

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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Digital Health

Background:

  • Limited clinical resources necessitate effective home-based, self-managed stroke rehabilitation strategies.
  • This study addresses the need for accessible upper extremity rehabilitation post-stroke.

Purpose of the Study:

  • To compare the efficacy of a home-based online self-managed program (Stroke Rehabilitation Online Guide - STRONG) against a paper exercise program (PEP) for improving upper extremity function in stroke survivors.
  • To evaluate the impact of STRONG on daily activity participation, movement quality, and self-efficacy.

Main Methods:

  • A randomized trial involving 43 stroke participants stratified by motor ability and self-efficacy.
  • Intervention: 6-week program of upper extremity exercises, with STRONG incorporating online video games and guided exercises, and PEP using written exercises.
  • Outcome Measures: Fugl-Meyer Upper Extremity Assessment, Wolf Motor Function Test, Motor Activity Log, Stroke Motivation Scale, and Self-Efficacy Scale.

Main Results:

  • Neither STRONG nor PEP demonstrated superiority in primary outcomes (Fugl-Meyer Upper Extremity Assessment, Wolf Motor Function Test-Timed).
  • STRONG participants reported significantly better quality of movement and increased amount of arm and hand use in daily activities.
  • Higher self-efficacy was observed in the STRONG group post-intervention, though not sustained at follow-up.

Conclusions:

  • Both home-based programs yielded modest motor improvements for stroke survivors.
  • The STRONG program, focusing on daily tasks and optional exercises, enhanced daily arm and hand function and adherence.
  • Home-based, self-managed rehabilitation incorporating digital tools shows promise for stroke recovery, warranting further investigation in larger trials.