Video Game Rehabilitation for Outpatient Stroke (VIGoROUS): protocol for a multi-center comparative effectiveness trial of in-home gamified constraint-induced movement therapy for rehabilitation of chronic upper extremity hemiparesis

Autor: Alli Hall, Victor W. Mark, Lynne V. Gauthier, David M. Morris, Alexandra Borstad, Gitendra Uswatte, Chelsea Kane, Edward Taub, Melissa Arakelian, Nancy Strahl
Rok vydání: 2016
Předmět:
030506 rehabilitation
Constraint-induced movement therapy
Hemiparesis
Activities of daily living
medicine.medical_treatment
lcsh:RC346-429
Virtual reality
law.invention
Study Protocol
0302 clinical medicine
Randomized controlled trial
law
Telerehabilitation
Activities of Daily Living
Outpatients
Protocol
Stroke
Rehabilitation
Stroke Rehabilitation
General Medicine
3. Good health
Exercise Therapy
Paresis
Research design
Motor
medicine.symptom
0305 other medical science
Adult
medicine.medical_specialty
Video game
Upper Extremity
03 medical and health sciences
Physical medicine and rehabilitation
CI therapy
medicine
Humans
lcsh:Neurology. Diseases of the nervous system
business.industry
medicine.disease
Video Games
Chronic Disease
Physical therapy
Quality of Life
Neurology (clinical)
business
030217 neurology & neurosurgery
Zdroj: BMC Neurology
BMC Neurology, Vol 17, Iss 1, Pp 1-18 (2017)
ISSN: 1471-2377
Popis: Background Constraint-Induced Movement therapy (CI therapy) is shown to reduce disability, increase use of the more affected arm/hand, and promote brain plasticity for individuals with upper extremity hemiparesis post-stroke. Randomized controlled trials consistently demonstrate that CI therapy is superior to other rehabilitation paradigms, yet it is available to only a small minority of the estimated 1.2 million chronic stroke survivors with upper extremity disability. The current study aims to establish the comparative effectiveness of a novel, patient-centered approach to rehabilitation utilizing newly developed, inexpensive, and commercially available gaming technology to disseminate CI therapy to underserved individuals. Video game delivery of CI therapy will be compared against traditional clinic-based CI therapy and standard upper extremity rehabilitation. Additionally, individual factors that differentially influence response to one treatment versus another will be examined. Methods This protocol outlines a multi-site, randomized controlled trial with parallel group design. Two hundred twenty four adults with chronic hemiparesis post-stroke will be recruited at four sites. Participants are randomized to one of four study groups: (1) traditional clinic-based CI therapy, (2) therapist-as-consultant video game CI therapy, (3) therapist-as-consultant video game CI therapy with additional therapist contact via telerehabilitation/video consultation, and (4) standard upper extremity rehabilitation. After 6-month follow-up, individuals assigned to the standard upper extremity rehabilitation condition crossover to stand-alone video game CI therapy preceded by a therapist consultation. All interventions are delivered over a period of three weeks. Primary outcome measures include motor improvement as measured by the Wolf Motor Function Test (WMFT), quality of arm use for daily activities as measured by Motor Activity Log (MAL), and quality of life as measured by the Quality of Life in Neurological Disorders (NeuroQOL). Discussion This multi-site RCT is designed to determine comparative effectiveness of in-home technology-based delivery of CI therapy versus standard upper extremity rehabilitation and in-clinic CI therapy. The study design also enables evaluation of the effect of therapist contact time on treatment outcomes within a therapist-as-consultant model of gaming and technology-based rehabilitation. Trial registration Clinicaltrials.gov, NCT02631850 .
Databáze: OpenAIRE
Externí odkaz: