Compared to conventional rehabilitation therapy, the full-immersive commercial game (CG) system, in the form of available video game, could safely provide more positive effect on health-related quality of life (HRQOL) and motor function in post-stroke patients. The study aims to perform the research from 2019/7/1 to 2021/6/30 and enrolls a total of 80 participants. Stroke participants are recruited from the rehabilitation ward of CGMH hospital. The inclusion criteria are (a) first-time unilateral cerebral stroke, (b) stroke onset less or equal to 1 year, (c) admission to the rehabilitation ward, (d) ages 20-80 years, (e) spasticity of paretic arm ≤ grade 2 in the Modified Ashworth Scale, and (f) no active medical problems such as fever, pneumonia, or scabies. The exclusion criteria are (a) brainstem or cerebellar stroke, (b) epilepsy history, including photosensitive epilepsy, (c) previous or active heart diseases, such as myocardial infarction or angina, (d) visuospatial problems related to stroke, such as hemianopia or hemineglect, (e) paretic upper limb reaches Brunnstrom recovery stage VI, (f) severe aphasia, (g) severe cognitive impairment, and (h) poor cooperation with assessments. All participants are randomly allocated to study group and control group. Participants in the control group receive conventional rehabilitation therapy over 50 minutes on weekdays. Participants in the study group receive conventional rehabilitation therapy over 50 minutes on weekdays and 7 sessions (flexible schedule in different day) of PlayStation®VR of 20 minutes each in the main 16-day study period. Pre-intervention, post-intervention, and 3-month follow-up HRQOL will be assessed by the Stroke Impact Scale 3.0. Motricity Index and Fugl-Meyer Assessment, Functional Independence Measure, and arm movement ratio will also be checked before intervention, after intervention, and at 3-month follow-up. The safety outcome, intervention-related adverse events or any serious adverse events, during study period will be recorded.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
80
Participants in the study group receive conventional rehabilitation therapy over 50 minutes on weekdays and 7 sessions (flexible schedule in different day) of PlayStation®VR of 20 minutes each in the main 16-day study period.
Chiayi Chang Gung Memorial Hospital
Pozi, Taiwan
Stroke Impact Scale (SIS) 3.0 Questionnaire
Health-Related Quality of Life
Time frame: Baseline (Pre-intervention at 2 days after enrollment)
Post-Intervention Change of Stroke Impact Scale (SIS) 3.0 Questionnaire
Post-intervention Health-Related Quality of Life
Time frame: Change from baseline SIS scores at 18 days after enrollment
3-Month Follow-Up Change of Stroke Impact Scale (SIS) 3.0 Questionnaire
3-month follow-up Health-Related Quality of Life
Time frame: Change from baseline SIS scores at 92 days after enrollment
Post-Intervention of Adverse Events or SAE
Proportion of intervention-related adverse events or SAE
Time frame: 16 days
Motricity Index (MI) Upper Extremity Test
Motor impairment and function
Time frame: Baseline (Pre-intervention) at 2 days after enrollment
Post-Intervention Change of Motricity Index (MI) Upper Extremity Test
Post-intervention motor impairment and function
Time frame: Change from baseline MI scores at 18 days after enrollment
3-Month Follow-Up Change of Motricity Index (MI) Upper Extremity Test
3-month follow-up motor impairment and function
Time frame: Change from baseline MI scores at 92 days after enrollment
Fugl-Meyer Assessment for Upper Extremity (FMA-UE)
Motor impairment and function
Time frame: Baseline (Pre-intervention) at 2 days after enrollment
Post-Intervention Change of Fugl-Meyer Assessment for Upper Extremity (FMA-UE)
Post-intervention motor impairment and function
Time frame: Change from baseline FMA-UE scores at 18 days after enrollment
3-Month Follow-Up Change of Fugl-Meyer Assessment for Upper Extremity (FMA-UE)
3-month follow-up motor impairment and function
Time frame: Change from baseline FMA-UE scores at 92 days after enrollment
Self-Care in Functional Independence Measure (FIM) Instrument
The FIM is an 18-item instrument measuring a person's level of disability in terms of burden of care in six areas including self-care, continence, mobility, transfers, communication, and cognition. Each of the 18 items is graded on a scale of 1-7 based on level of independence in that item (1 = total assistance required, 7 = complete independence). Six items (eating, grooming, bathing, dressing upper body, dressing lower body, and toileting) of self care will be scored and summed in this study.
Time frame: Baseline (Pre-intervention) at 2 days after enrollment
Post-Intervention Change of Self-Care in Functional Independence Measure (FIM) Instrument
The FIM is an 18-item instrument measuring a person's level of disability in terms of burden of care in six areas including self-care, continence, mobility, transfers, communication, and cognition. Each of the 18 items is graded on a scale of 1-7 based on level of independence in that item (1 = total assistance required, 7 = complete independence). Six items (eating, grooming, bathing, dressing upper body, dressing lower body, and toileting) of self care will be scored and summed in this study.
Time frame: Change from baseline self-care scores at 18 days after enrollment
3-Month Follow-Up Change of Self-Care in Functional Independence Measure (FIM) Instrument
The FIM is an 18-item instrument measuring a person's level of disability in terms of burden of care in six areas including self-care, continence, mobility, transfers, communication, and cognition. Each of the 18 items is graded on a scale of 1-7 based on level of independence in that item (1 = total assistance required, 7 = complete independence). Six items (eating, grooming, bathing, dressing upper body, dressing lower body, and toileting) of self care will be scored and summed in this study.
Time frame: Change from baseline self-care scores at 92 days after enrollment
Arm Movement Ratio (AMR) Test
The AMR, the ratio of arm use duration between the more and less affected arm, is detected and calculated by an accelerometer. The participants are asked to wear one accelerometer (ActiGraph wGT3x-BT, ActiGraph, LLC., Pensacola, FL, USA) on each arm for 7 hours.
Time frame: Baseline (Pre-intervention) at 1 day after enrollment
Post-Intervention Change of Arm Movement Ratio (AMR) Test
The AMR, the ratio of arm use duration between the more and less affected arm, is detected and calculated by an accelerometer. The participants are asked to wear one accelerometer (ActiGraph wGT3x-BT, ActiGraph, LLC., Pensacola, FL, USA) on each arm for 7 hours.
Time frame: Change from baseline AMR scores at 19 days after enrollment
3-Month Follow-Up Change of Arm Movement Ratio (AMR) Test
The AMR, the ratio of arm use duration between the more and less affected arm, is detected and calculated by an accelerometer. The participants are asked to wear one accelerometer (ActiGraph wGT3x-BT, ActiGraph, LLC., Pensacola, FL, USA) on each arm for 7 hours.
Time frame: Change from baseline AMR scores at 93 days after enrollment
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