Open Access

Improving motor function after chronic stroke by interactive gaming with a redesigned MR‑compatible hand training device

  • Authors:
    • Loukas G. Astrakas
    • Gianluca De Novi
    • Mark P. Ottensmeyer
    • Christian Pusatere
    • Shasha Li
    • Michael A. Moskowitz
    • A. Aria Tzika
  • View Affiliations

  • Published online on: January 22, 2021     https://doi.org/10.3892/etm.2021.9676
  • Article Number: 245
  • Copyright: © Astrakas et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

New rehabilitation strategies enabled by technological developments are challenging the prevailing concept of there being a limited window for functional recovery after stroke. In this study, we examined the utility of a robot‑assisted therapy used in combination with a serious game as a rehabilitation and motor assessment tool in patients with chronic stroke. We evaluated 928 game rounds from 386 training sessions of 8 patients who had suffered an ischemic stroke affecting middle cerebral artery territory that incurred at least 6 months prior. Motor function was assessed with clinical motor scales, including the Fugl‑Meyer upper extremity (FM UE) scale, Action Research Arm Test, Modified Ashworth scale and the Box and Blocks test. Robotic device output measures (mean force, force‑position correlation) and serious game score elements (collisions, rewards and total score) were calculated. A total of 2 patients exhibited a marginal improvement after a 10‑week training protocol according to the FM UE scale and an additional patient exhibited a significant improvement according to Box and Blocks test. Motor scales showed strong associations of robotic device parameters and game metrics with clinical motor scale scores, with the strongest correlations observed for the mean force (0.677<Ρ<0.869), followed by the number of collisions (‑0.670<Ρ<‑0.585). Linear regression analysis showed that these indices were independent predictors of motor scale scores. In conclusion, a robotic device linked to a serious game can be used by patients with chronic stroke and induce at least some clinical improvements in motor performance. Robotic device output parameters and game score elements associate strongly with clinical motor scales and have the potential to be used as predictors in models of rehabilitation progress.
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March-2021
Volume 21 Issue 3

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Astrakas LG, De Novi G, Ottensmeyer MP, Pusatere C, Li S, Moskowitz MA and Tzika A: Improving motor function after chronic stroke by interactive gaming with a redesigned MR‑compatible hand training device. Exp Ther Med 21: 245, 2021.
APA
Astrakas, L.G., De Novi, G., Ottensmeyer, M.P., Pusatere, C., Li, S., Moskowitz, M.A., & Tzika, A. (2021). Improving motor function after chronic stroke by interactive gaming with a redesigned MR‑compatible hand training device. Experimental and Therapeutic Medicine, 21, 245. https://doi.org/10.3892/etm.2021.9676
MLA
Astrakas, L. G., De Novi, G., Ottensmeyer, M. P., Pusatere, C., Li, S., Moskowitz, M. A., Tzika, A."Improving motor function after chronic stroke by interactive gaming with a redesigned MR‑compatible hand training device". Experimental and Therapeutic Medicine 21.3 (2021): 245.
Chicago
Astrakas, L. G., De Novi, G., Ottensmeyer, M. P., Pusatere, C., Li, S., Moskowitz, M. A., Tzika, A."Improving motor function after chronic stroke by interactive gaming with a redesigned MR‑compatible hand training device". Experimental and Therapeutic Medicine 21, no. 3 (2021): 245. https://doi.org/10.3892/etm.2021.9676