%0 Journal Article
%T Rehabilitation of the upper arm early after stroke: Video games versus conventional rehabilitation. A randomized controlled trial
%+ Euromov (EuroMov)
%+ Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
%+ Système Multi-agent, Interaction, Langage, Evolution (SMILE)
%+ Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)
%+ Institut d’Imagerie Fonctionnelle Humaine [CHU Montpellier] (I2FH)
%+ Laboratoire Charles Coulomb (L2C)
%+ Département de Médecine Physique et de Réadaptation [Montpellier]
%+ Département de neurologie [Montpellier]
%+ Centre Mutualiste de Réeducation Neurologique Propara (PROPARA)
%+ Dynamique des capacités humaines et des conduites de santé (EPSYLON)
%A Laffont, Isabelle
%A Froger, Jerome
%A Jourdan, Claire
%A Bakhti, Karima
%A van Dokkum, Liesjet E.H.
%A Gouaich, Abdelkader
%A Bonnin, Huei Yune
%A Armingaud, Philippe
%A Jaussent, Audrey
%A Picot, Marie Christine
%A Le Bars, Emmanuelle
%A Dupeyron, Arnaud
%A Arquizan, Caroline
%A Gélis, Anthony
%A Mottet, Denis
%< avec comité de lecture
%@ 1877-0657
%J Annals of Physical and Rehabilitation Medicine
%I Elsevier Masson
%V 63
%N 3
%P 173-180
%8 2020-05
%D 2020
%R 10.1016/j.rehab.2019.10.009
%K Rehabilitation
%K Stroke
%K Upper limb
%K Video games
%Z Computer Science [cs]/Human-Computer Interaction [cs.HC]
%Z Humanities and Social Sciences
%Z Life Sciences [q-bio]/Human health and pathologyJournal articles
%X Few rehabilitation methods have proven their efficacy in increasing sensori-motor recovery and/or function of the upper limb (UL) after stroke. Video games (VGs) are promising tools in this indication.OBJECTIVE: To compare UL rehabilitation by using VGs and conventional rehabilitation (CR) in patients with sub-acute stroke.DESIGN: Single-blind, multicentric trial, with central randomization and stratification by center.SETTING: Physical and rehabilitation medicine departments of 2 university hospitals.PARTICIPANTS: Adults within 3 months after a first vascular cerebral accident, with UL Fugl Meyer Score (UL-FMS)<30/66 and without major cognitive impairment.INTERVENTION: A 45-min additional session of conventional occupational therapy (OT) or a VG-based OT session as add-on therapy to usual rehabilitation programs, 5 days/week for 6 weeks.MAIN OUTCOME MEASURES: Primary outcome: UL-FMS. Secondary outcome: Box and Block Test (BBT), Wolf Motor Function test (WMFT), Motor Activity Log (MAL), Barthel Index and quality of life (SF-36).RESULTS: We included 51 patients (20 women) at a mean (SD) of 27.2 (19.4) days post-stroke (mean age 58 years [range 24-83]), 26 in the CR group and 25 in the VG group (23 in each group at 6-month follow-up). The mean duration of the additional rehabilitation session was similar in both groups: 29.3 (4.3) vs 28.0 (4.4) min in CR and VG groups. Shoulder pain occurred in 4 patients in the VG group versus 7 in the CR group. At day 45, gain in UL-FMS did not significantly differ between the groups (CR mean 17.8 [14.6] vs VG 24.1 [14.8]; P=0.10), whereas gain in BBT was doubled in the VG group (CR 7.4 [12.2] vs VG 15.7 [16.3]; P=0.02). At 6-month follow-up, the study was inconclusive about between-group differences in UL-FMS, BBT and other criteria. Post-hoc analysis showed that gains in UL-FMS or BBT were significantly higher in the VG than CR group for patients included within 30 days post-stroke.CONCLUSION: In general, we cannot conclude that video gaming and conventional OT led to different long-term sensorimotor recovery of the UL after sub-acute stroke. However, when applied within the first month after stroke, video gaming was more efficient than conventional rehabilitation on both sensorimotor recovery and gross grasping function.
%G English
%L hal-02526695
%U https://hal.umontpellier.fr/hal-02526695
%~ SHS
%~ CNRS
%~ UNIV-MONTP1
%~ UNIV-MONTP3
%~ EM-ALES
%~ L2C
%~ SMILE
%~ LIRMM
%~ MIPS
%~ BS
%~ UNIV-MONTPELLIER
%~ EPSYLON
%~ EUROMOV-DHM
%~ UM-2015-2021