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 readmissions.
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 these results.”
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.