Scimex: Wii is the gift that keeps on giving to people after they have had a stroke, according to two studies from Neuroscience Research Australia (NeuRA). New research, led by Dr Penelope McNulty, shows that Wii-based Movement Therapy (WMT) not only restores upper limb mobility, but also improves lower limb movement and cardiovascular health in participants. Both studies compared WMT with modified Constraint-induced Movement Therapy (mCMIT) and found that WMT boasts additional benefits. While CMIT is currently considered best-practice in stroke rehabilitation, results from these studies indicate that WMT is equally as effective, with better lifestyle outcomes at six months.
Stroke is one of the leading causes of disability in Australia, with
almost 440,000 people living with the after-effects. This is predicted
to increase to 709,000 in 2032. Sixty-five percent of those living with
stroke also suffer a disability that impedes their ability to carry out
daily living activities unassisted.
Sedentary behaviour is common after a person has suffered a stroke,
with cardiovascular fitness typically around half that of healthy people
of a similar age. Poor cardiovascular fitness is a significant risk
factor for subsequent stroke and is responsible for 19 percent of stroke
Most post-stroke therapies focus on regaining walking ability, which
is important not only for mobility but to avoid social isolation and
depression associated with the loss of mobility. While WMT is
specifically targeted at rehabilitating upper-limb functionality,
researchers found it also improved lower limb mobility.
“Our study shows us that Wii-based therapy provides three essential
benefits to stroke survivors,” says neurophysiologist Dr Penelope
McNulty. “After receiving this treatment their stepping as well as arm
and hand movements were improved and many enjoyed the additional benefit
of increased cardiovascular fitness. We were pleasantly surprised with
WMT provides neurorehabilitation, resulting in multi-domain improvements in limb movement and fitness, according to researchers.
The Wii-based therapy involved 60-minute sessions per day of an
individually tailored program involving Wii-Sports (golf, bowling,
baseball, tennis or boxing). Game activities were introduced and varied
according to motor function and progress of each patient.
Participants in the mCMIT group wore a padded mitt on the less
affected hand for <90% of walking hours, to encourage use of the more
affected upper limb. Activities of mCIMT were tailored to individual
deficits and were predominantly performed seated.
“Our research emphasises the need to increase physical activity
post-stroke. We have shown that WMT is as effective for upper limb
rehabilitation as mCIMT and, crucially, it has the added benefit of
having higher patient preference, so they’re likely to adhere to their
rehabilitation training for longer.”
Researchers say that WMT can be tailored to address aerobic
deconditioning that affects around 50 percent of stroke survivors
without compromising its focus on improving upper limb function.
Dr McNulty believes that with few minor modifications, Wii-based
Movement Therapy can be individualised to provide a carefully controlled
cardiovascular rehabilitation option for stroke survivors.
“Our research highlights the importance of developing a therapy that
focuses on enabling increased independence post-stroke, and that the
Wii-based Movement Therapy can deliver benefits that have been
overlooked by current standard therapies.”
The studies were published in Disability and Rehabilitation and Topics in Stroke Rehabilitation.