Post-stroke Hemiparetic Patients (at Least 6 Months Post Stroke), Age Between 18-75 Years
Conditions
Keywords
Hemiparesis,, Rehabilitation,, WII,, Upper limb,, Movement strategies.
Brief summary
The purpose of this study is to evaluate changes in strategies of hemiparetic upper limb movement in chronic stroke patients following rehabilitation using the Nintendo Wii. The investigators hypothesize that patients will increase their use of compensatory strategies following this rehabilitation.
Detailed description
The principal aim of this study is to evaluate changes in strategies of hemiparetic upper limb movement in chronic stroke patients following twelve one hour sessions of rehabilitation using the Nintendo Wii over a period of four weeks, and to compare with a group of patients receiving traditional upper limb rehabilitation of the same duration. The investigators hypothesize that the use of compensatory strategies will increase in the group receiving the Wii rehabilitation while they will decrease in the group receiving traditional rehabilitation. The investigators further hypothesize that this will have an impact on the functional benefit with a greater improvement of function in the group receiving traditional rehabilitation.
Interventions
BEHAVIORALWII Rehabilitation
30 patients will receive Wii rehabilitation of 15 minutes (tennis, boxing and golf), in comparison with 10 healthy subjects.
BEHAVIORALTraditional rehabilitation
30 patients will receive the traditional rehabilitation.
Sponsors
Assistance Publique - Hôpitaux de Paris
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
Age 18 to 75 years Right handed Hemiparesis following vascular lesions of a single hemisphere of more than 6 months duration. Not a regular 'Wii' user Able to bring the hand to the mouth. No botulinum toxin injections within the previous 3 months Having given informed consent
Exclusion criteria
Major cognitive or perceptive deficits Cerebellar syndrome Epileptic fits within the previous year Pacemaker user Un-corrected visual deficits No social security
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Degree of elbow extension during an active reaching task | 6 minutes |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinical | 1 hour and half | Pain (VAS) (evaluated at the beginning and end of each session) Borg scale of perceived effort (evaluated at the end of each session) Fugl-Meyer (upper limb section) (evaluated before and after the rehabilitation period) Box and Block test (evaluated before and after the rehabilitation period) Action Research Arm Test (ARAT) (evaluated before and after the rehabilitation period) Motor Activity Log (MAL) (evaluated before and after the rehabilitation period) Stroke Impact scale (SIS) (evaluated before and after the rehabilitation period) Satisfaction (VAS) (evaluated at the end of the rehabilitation period) |
| Kinematic measures | 45 minutes | Parameters relating to hand trajectory (smoothness, curvature, velocity) and upper limb joint angles (trunk flexion, shoulder abduction) during an active reaching task using an electromagnetic motion capture system. (evaluated before and after the rehabilitation period) |
| Kinetic measures | 45 minutes | Capacity to regulate grip force during a visuo-motor task using an instrumented device. (evaluated before and after the rehabilitation period) |
| Movement strategies during 'Wii rehabilitation' | 45 minutes | The number and extent of the movements made with the upper limb during 'wii rehabilitation' will be recorded using accelerometers. |
| MRI | 1 hour | The extent and localization of the lesions will be evaluated using MRIcro and correlations will be sought between the lesion locations and the kinematic and kinetic characteristics of the patients. Evaluations will be carried out during the week preceding and the week following the rehabilitation period. The evaluating therapist will be blinded to the type of rehabilitation received by the patient. |
Countries
France
Outcome results
None listed