Viabilidad, seguridad y diversión durante el entrenamiento con Wii Balance Board Exergame en personas con ictus subagudo
Feasibility, Safety, and Enjoyment during Wii Balance Board Exergame Training among Individuals with Sub-acute Stroke
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
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Introducción. Nintendo® Wii es una plataforma de realidad virtual no inmersiva que funciona integrada con la Wii Balance Board como un sistema de biofeedback para la rehabilitación del equilibrio en pacientes después de un accidente cerebrovascular.
Objetivo. El objetivo principal era evaluar la viabilidad de emplear el entrenamiento con Wii Balance Board como un enfoque de tratamiento independiente en la práctica clínica para pacientes con apoplejía subaguda. El objetivo secundario era evaluar el estado de disfrute durante el entrenamiento con la Wii Balance Board y calcular el tamaño del efecto para un estudio definitivo.
Método. El diseño del estudio fue un ensayo piloto de control aleatorio. Reclutamos a 20 pacientes con AVC subagudo utilizando una técnica de aleatorización en bloque. Los participantes del grupo experimental recibieron entrenamiento en la Wii Balance Board durante 12 sesiones de hasta 2 semanas. Los participantes del grupo de control recibieron tratamientos estándar de fisioterapia para el equilibrio en posición erguida durante 12 sesiones de hasta 2 semanas. Las medidas de los resultados fueron la documentación clínica-log para las pruebas de viabilidad, el cuestionario de disfrute del exergame, el mini-BESTest y los FIMs.
Resultados. La tasa de matrícula y retención del estudio fue respectivamente del 80% (n = 20) y 70% en cada grupo (n = 7). Se informó que la tasa de incidencia de eventos adversos del entrenamiento Wii Fit fue del 40% (n = 4), junto con una tasa moderada de disfrute (promedio sd = 50,10 14,69; n = 10). La intervención experimental no ofreció beneficios significativos sobre la intervención de control (p = 0,539, 0,622; d = -0,280, -0,224 de Cohen; IC 95%: -1,15 a 0,60, -1,10 a 0,65).
Conclusión. El entrenamiento de exergames basado en la Wii Balance Board puede considerarse un enfoque factible y seguro para el entrenamiento del equilibrio entre pacientes con ACV subagudo. Sin embargo, los exerjuegos no pueden reemplazar la rehabilitación de equilibrio de atención estándar debido a su escasa eficacia a corto plazo.
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- Feigin VL, Brainin M, Norrving B, Martins S, Sacco RL, Hacke W, et al. World Stroke Organization (WSO): Global Stroke Fact Sheet 2022. Int J Stroke [Internet]. 2022;17(1):18-29. doi: https://doi.org/10.1177/17474930211065917
- Jones SP, Baqai K, Clegg A, Georgiou R, Harris C, Holland E-J, et al. Stroke in India: A systematic review of the incidence, prevalence, and case fatality. Int J Stroke [Internet]. 2022;17(2):132-40. doi: https://doi.org/10.1177/17474930211027834
- Kamphuis JF, de Kam D, Geurts ACH, Weerdesteyn V. Is weight-bearing asymmetry associated with postural instability after stroke? A systematic review. Stroke Res Treat [Internet]. 2013;2013:692137. doi: https://doi.org/10.1155/2013/692137
- Szopa A, Domagalska-Szopa M, Lasek-Bal A, Żak A. The link between weight shift asymmetry and gait disturbances in chronic hemiparetic stroke patients. Clin Interv Aging [Internet]. 2017;12:2055-62. doi: https://doi.org/10.2147/CIA.S144795
- Whiteneck GG. Measuring what matters: Key rehabilitation outcomes. Arch Phys Med Rehabil [Internet]. 1994;75:1073-6. doi: https://doi.org/10.1016/0003-9993(94)90080-9
- Noh H-J, Lee S-H, Bang D-H. Three-Dimensional Balance Training Using Visual Feedback on Balance and Walking Ability in Subacute Stroke Patients: A Single-Blinded Randomized Controlled Pilot Trial. J Stroke Cerebrovasc Dis [Internet]. 2019;28(4):994-1000. doi: https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.12.016
- Bovim LPV, Valved L, Bleikli B, Geitung AB, Soleim H, Bogen B. Theoretical Rationale for Design of Tasks in a Virtual Reality-Based Exergame for Rehabilitation Purposes. Front Aging Neurosci [Internet]. 2021;13:734223. doi: https://doi.org/10.3389/fnagi.2021.734223
- Choi D, Choi W, Lee S. Influence of Nintendo Wii Fit Balance Game on Visual Perception, Postural Balance, and Walking in Stroke Survivors: A Pilot Randomized Clinical Trial. Games Health J [Internet]. 2018;7(6):377-84. doi: https://doi.org/10.1089/g4h.2017.0126
- Hung J-W, Chou C-X, Chang H-F, Wu W-C, Hsieh Y-W, Chen P-C, et al. Cognitive effects of weight-shifting controlled exergames in patients with chronic stroke: a pilot randomized comparison trial. Eur J Phys Rehabil Med [Internet]. 2017;53(5):694-702. doi: https://doi.org/10.23736/S1973-9087.17.04516-6
- Montoro-Cárdenas D, Cortés-Pérez I, Ibancos-Losada MR, Zagalaz-Anula N, Obrero-Gaitán E, Osuna-Pérez MC. Nintendo® Wii Therapy Improves Upper Extremity Motor Function in Children with Cerebral Palsy: A Systematic Review with Meta-Analysis. Int J Environ Res Public Health [Internet]. 2022;19:1-19. doi: https://doi.org/10.3390/ijerph191912343
- Rohof B, Betsch M, Rath B, Tingart M, Quack V. The Nintendo® Wii Fit Balance Board can be used as a portable and low-cost posturography system with good agreement compared to established systems. Eur J Med Res [Internet]. 2020;25(1):44. doi: https://doi.org/10.1186/s40001-020-00445-y
- Lee MM, Lee KJ, Song CH. Game-Based Virtual Reality Canoe Paddling Training to Improve Postural Balance and Upper Extremity Function: A Preliminary Randomized Controlled Study of 30 Patients with Subacute Stroke. Med Sci Monit [Internet]. 2018;24:2590-8. doi: https://doi.org/10.12659/MSM.906451
- Utkan Karasu A, Balevi Batur E, Kaymak Karataş G. Effectiveness of Wii-based rehabilitation in stroke: A randomized controlled study. J Rehabil Med [Internet]. 2018;50(5):406-12. doi: https://doi.org/10.2340/16501977-2331
- Ghazavi Dozin SM, Mohammad Rahimi N, Aminzadeh R. Wii Fit-Based Biofeedback Rehabilitation Among Post-Stroke Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trial. Biol Res Nurs [Internet]. 2024;26(1):5-20. doi: https://doi.org/10.1177/10998004231180316
- Jeon M-J, Moon J-H, Cho H. Effects of virtual reality combined with balance training on upper limb function, balance, and activities of daily living in persons with acute stroke: a preliminary study. PTRS [Internet]. 2019;8:187-93. doi: https://doi.org/10.14474/ptrs.2019.8.4.187
- Morone G, Tramontano M, Iosa M, Shofany J, Iemma A, Musicco M, et al. The Efficacy of Balance Training with Video Game-Based Therapy in Subacute Stroke Patients: A Randomized Controlled Trial. BioMed Res Int [Internet]. 2014;2014:1-6. doi: https://doi.org/10.1155/2014/580861
- Anwar N, Karimi H, Ahmad A, Gilani SA, Khalid K, Aslam AS, et al. Virtual Reality Training Using Nintendo Wii Games for Patients With Stroke: Randomized Controlled Trial. JMIR Serious Games [Internet]. 2022;10(2):e29830. doi: https://doi.org/10.2196/29830
- Bian M, Shen Y, Huang Y, Wu L, Wang Y, He S, et al. A non-immersive virtual reality-based intervention to enhance lower-extremity motor function and gait in patients with subacute cerebral infarction: A pilot randomized controlled trial with 1-year follow-up. Front Neurol [Internet]. 2022;13:985700. doi: https://doi.org/10.3389/fneur.2022.985700
- Pintado-Izquierdo S, Cano-de-la-Cuerda R, Ortiz-Gutiérrez RM. Video Game-Based Therapy on Balance and Gait of Patients with Stroke: A Systematic Review. Appl Sci [Internet]. 2020;10(18):1-33. doi: https://doi.org/10.3390/app10186426
- Saeedi S, Ghazisaeedi M, Rezayi S. Applying Game-Based Approaches for Physical Rehabilitation of Poststroke Patients: A Systematic Review. J Healthc Eng [Internet]. 2021;2021:1-27. doi: https://doi.org/10.1155/2021/9928509
- Domínguez-Téllez P, Moral-Muñoz JA, Casado-Fernández E, Salazar-Couso A, Lucena-Antón D. Efectos de la realidad virtual sobre el equilibrio y la marcha en el ictus: revisión sistemática y metaanálisis. Rev Neurol [Internet]. 2019;69:223-34. doi: https://doi.org/10.33588/rn.6906.2019063
- Sana V, Ghous M, Kashif M, Albalwi A, Muneer R, Zia M. Effects of vestibular rehabilitation therapy versus virtual reality on balance, dizziness, and gait in patients with subacute stroke: A randomized controlled trial. Medicine (Baltimore) [Internet]. 2023;102(24):e33203. doi: https://doi.org/10.1097/MD.0000000000033203
- Ruff J, Wang TL, Quatman-Yates CC, Phieffer LS, Quatman CE. Commercially available gaming systems as clinical assessment tools to improve value in the orthopaedic setting: A systematic review. Injury [Internet]. 2015;46(2):178-83. doi: https://doi.org/10.1016/j.injury.2014.08.047
- Eldridge SM, Chan CL, Campbell MJ, Bond CM, Hopewell S, Thabane L, et al. CONSORT 2010 statement: extension to randomised pilot and feasibility trials. BMJ [Internet]. 2016;355:i5239. doi: https://doi.org/10.1136/bmj.i5239
- Ciorap R, Andritoi D, Luca C, Corciova C. Monitoring of Cardiovascular Parameters During Rehabilitation After Stroke Event. In: Vlad S, Roman NM, editors. 6th International Conference on Advancements of Medicine and Health Care through Technology [Internet]. 2018 Oct 17-20; Cluj-Napoca, Romania. Springer Singapore; 2019. p. 103-7. doi: https://doi.org/10.1007/978-981-13-6207-1_17
- Fitzgerald A, Huang S, Sposato K, Wang D, Claypool M, Agu E. The Exergame Enjoyment Questionnaire (EEQ): An Instrument for Measuring Exergame Enjoyment. In Bui TX, editor. Proceedings of the 53rd Annual Hawaii International Conference on System Sciences [Internet]. 2020 Jan 7-10; Maui, Hawaii. HICSS; 2020. p. 3397-406. doi: https://doi.org/10.24251/HICSS.2020.416
- Chinsongkram B, Chaikeeree N, Saengsirisuwan V, Viriyatharakij N, Horak FB, Boonsinsukh R. Reliability and Validity of the Balance Evaluation Systems Test (BESTest) in People With Subacute Stroke. Phys Ther [Internet]. 2014;94(11):1632–43. doi: https://doi.org/10.2522/ptj.20130558
- Segal ME, Schall RR. Determining functional/health status and its relation to disability in stroke survivors. Stroke [Internet]. 1994;25(12):2391-7. doi: https://doi.org/10.1161/01.STR.25.12.2391
- National Center for Complementary and Integrative Health (NIH) [Internet]. Bethesda: NIH; c2024. Pilot Studies: Common Uses and Misuses; n.d. [cited 2024 Jul 16]; [about 8 screens]. Available from: https://www.nccih.nih.gov/grants/pilot-studies-common-uses-and-misuses
- OpenAI. ChatGPT (Version 3.0) [Large language model]. 2023.
- Locke DEC, Chandler Greenaway M, Duncan N, Fields JA, Cuc AV, Hoffman Snyder C, et al. A patient-centered analysis of enrollment and retention in a randomized behavioral trial of two cognitive rehabilitation interventions for Mild Cognitive Impairment. J Prev Alzheimers Dis [Internet]. 2014;1(3):143-50. doi: https://doi.org/10.14283/jpad.2014.27
- Randriambelonoro M, Perrin C, Blocquet A, Kozak D, Toyas Fernandez J, Marfaing T, et al. Hospital-to-Home Transition for Older Patients: Using Serious Games to Improve the Motivation for Rehabilitation – a Qualitative Study. Journal of population ageing [Internet]. 2020;13:187-205. doi: https://doi.org/10.1007/s12062-020-09274-7
- Klompstra L, Jaarsma T, Olsson M, Bayes-Genis A, Lupon J, Gonzales B, et al. Health care professionals expectations on mobile exergaming to decrease sedentary time in patients with heart failure. European Journal of Cardiovascular Nursing [Internet]. 2024;23(Suppl 1):zvae098.121. doi: https://doi.org/10.1093/eurjcn/zvae098.121
- Jenkins L, Gonzaga S, Jedlanek E, Kim G, Raghavan P. Addressing the Operational Challenges for Outpatient Stroke Rehabilitation. Am J Phys Med Rehabil [Internet]. 2023;102(2S):S61-7. doi: https://doi.org/10.1097/PHM.0000000000002145
- Chavda K, Prakash V. Transport use limitations and its association with social participation among patients with stroke living in rural India. Disabil Rehabil [Internet]. 2024;46(17):3980-4. doi: https://doi.org/10.1080/09638288.2023.2260740
- O’Callaghan G, Fahy M, O’Meara S, Chawke M, Waldron E, Corry M, et al. Transitioning to home and beyond following stroke: a prospective cohort study of outcomes and needs. BMC Health Serv Res [Internet]. 2024;24(1):449. doi: https://doi.org/10.1186/s12913-024-10820-8
- Lourido C, Waghoo Z, Wazir HK, Bhagat N, Kapila V. Using Capability Maps Tailored to Arm Range of Motion in VR Exergames for Rehabilitation. arXiv. 2404.12504 [Internet]. 2024;1. doi: https://doi.org/10.48550/ARXIV.2404.12504
- Vadas D, Prest K, Turk A, Tierney S. Understanding the facilitators and barriers of stroke survivors’ adherence to recovery-oriented self-practice: a thematic synthesis. Disabil Rehabil [Internet]. 2022;44(22):6608-19. doi: https://doi.org/10.1080/09638288.2021.1968512
- Large AM, Bediou B, Cekic S, Hart Y, Bavelier D, Green CS. Cognitive and Behavioral Correlates of Achievement in a Complex Multi-Player Video Game. Media Commun 2019;7:198–212. doi: https://doi.org/10.17645/mac.v7i4.2314
- Xu L, Yu T, Gao R, Zhang X, Pang Y, Yu T, et al. Maintenance effects of a gamification intervention on motivation and physical activity in patients with coronary heart disease: intermediate results of a randomized controlled trial. European Heart Journal [Internet]. 2022;43(Suppl 2):ehac544.2440. doi: https://doi.org/10.1093/eurheartj/ehac544.2440
- Rotstein MS, Zimmerman‐Brenner S, Davidovitch S, Ben‐Haim Y, Koryto Y, Sion R, et al. Gamified Closed‐Loop Intervention Enhances Tic Suppression in Children: A Randomized Trial. Mov Disord [Internet]. 2024;39(8):1310-22. doi: https://doi.org/10.1002/mds.29875
- Draghi TTG, Smits-Engelsman B, Godoi-Jacomassi D, Cavalcante Neto JL, Jelsma D, Tudella E. Short- and Long-Term Changes in Balance After Active Video Game Training in Children With and Without Developmental Coordination Disorder: A Randomized Controlled Trial. Motor Control [Internet]. 2024;28(2):174-92. doi: https://doi.org/10.1123/mc.2023-0070
- Fotopoulos D, Ladakis I, Kilintzis V, Chytas A, Koutsiana E, Loizidis T, et al. Gamifying rehabilitation: MILORD platform as an upper limb motion rehabilitation service. Front Comput Sci [Internet]. 2022;4:932342. doi: https://doi.org/10.3389/fcomp.2022.932342
- Hsiao H-Y, Gray VL, Borrelli J, Rogers MW. Biomechanical control of paretic lower limb during imposed weight transfer in individuals post-stroke. J Neuroeng Rehabil [Internet]. 2020;17(1):140. doi: https://doi.org/10.1186/s12984-020-00768-1
- Barbanchon C, Mouraux D, Baudry S. Repeated exposure to virtual reality decreases reliance on visual inputs for balance control in healthy adults. Human movement science [Internet]. 2024;96:103236. doi: https://doi.org/10.1016/j.humov.2024.103236
- Tsurayya G, Duta TF, Naufal MA, Alina M, Isitua CC, Ohanu EC. Acceptance, safety, and impact on quality of life of exergame for elderly patients with neurodegenerative diseases: A systematic review and meta-analysis. Narra X [Internet]. 2023;1(3):1-12. doi: https://doi.org/10.52225/narrax.v1i3.94
- Molhemi F, Monjezi S, Mehravar M, Shaterzadeh-Yazdi M-J, Salehi R, Hesam S, et al. Effects of Virtual Reality vs Conventional Balance Training on Balance and Falls in People With Multiple Sclerosis: A Randomized Controlled Trial. Arch Phys Med Rehabil [Internet]. 2021;102(2):290-9. doi: https://doi.org/10.1016/j.apmr.2020.09.395
- Begde A, Alqurafi A, Pain MTG, Blenkinsop G, Wilcockson T, Hogervorst E. The Effectiveness of Home-based Exergames Training on Cognition and Balance in Older Adults: A Comparative Quasi-Randomized Study of Two Exergame Interventions. Innov Aging [Internet]. 2023;7(8):igad102. doi: https://doi.org/10.1093/geroni/igad102
- Norouzkhani N, Hamednia M, Aalaei S. Application of Mobile-Based Games in The Rehabilitation of Stroke Survivors. Simulation & Gaming [Internet]. 2023;54(2):184-208. doi: https://doi.org/10.1177/10468781231158048
- Ajani OS, Mallipeddi R. Pareto-based Dynamic Difficulty Adjustment of a competitive exergame for arm rehabilitation. International Journal of Human-Computer Studies [Internet]. 2023;178:103100. doi: https://doi.org/10.1016/j.ijhcs.2023.103100
- Huber SK, Knols RH, Held JPO, Betschart M, De Bruin ED. PEMOCS: Evaluating the effects of a concept-guided, PErsonalized, MOtor-Cognitive exergame training on cognitive functions and gait in chronic Stroke – study protocol for a randomized controlled trial. Research Square [preprint]. 2024. doi: https://doi.org/10.21203/rs.3.rs-3868318/v1
- Zahid H, Jamil A, Khalid F. Effects of relaxing music therapy along with task-oriented training of lower limb on balance and functional independence in patients with chronic stroke: a randomized clinical trial. Pakistan Journal of Rehabilitation [Internet]. 2024;13(1):138-45. doi: https://doi.org/10.36283/pjr.zu.13.1/017
- Zhao C, Zhao C, Zhao M, Wang L, Guo J, Zhang L, et al. Effect of Exergame Training on Working Memory and Executive Function in Older Adults. Sustainability [Internet]. 2022;14(17):1-11. doi: https://doi.org/10.3390/su141710631
- Piccinini G, Imbimbo I, Ricciardi D, Coraci D, Santilli C, Lo Monaco MR, et al. The impact of cognitive reserve on the effectiveness of balance rehabilitation in Parkinson’s disease. Eur J Phys Rehabil Med [Internet]. 2018;54(4):554-9. doi: https://doi.org/10.23736/S1973-9087.17.04837-7
- Rogers C, Shamley D, Amosun S. Older Adults’ Experience of an Exergaming Intervention to Improve Balance and Prevent Falls: A Nested Explanatory Qualitative Study. Appl Sci [Internet]. 2021;11(24):1-17. doi: https://doi.org/10.3390/app112411678