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Rehabilitation of the upper arm early after stroke: Video games versus conventional rehabilitation / Isabelle Laffont in Annals of physical and rehabilitation medicine, Vol. 63 n° 3 (May 2020)
[article] Rehabilitation of the upper arm early after stroke: Video games versus conventional rehabilitation : A randomized controlled trial [texte imprimé] / Isabelle Laffont (1965-....), Auteur ; Jérôme Froger (1968-....), Auteur ; Claire Jourdan, Auteur . - 2020 . - p. 173-180.
Langues : Anglais (eng) Français (fre)
in Annals of physical and rehabilitation medicine > Vol. 63 n° 3 (May 2020) . - p. 173-180
Catégories : PATHOLOGIE
RandomisationUtilisation du hasard dans la constitution d'un échantillon pour une étude ou une enquête.
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Tags : Stroke Upper limb Video games Rehabilitation Résumé : Background: 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) 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 2483]), 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.
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