A KinectTM-based, task-specific, virtual reality rehabilitation game for patients with stroke: A usability test and clinical trial (Preprint)
BACKGROUND The use of Virtual Reality (VR) is popular in clinical rehabilitation, but the effects of using commercial VR games in stroke patients have been mixed. OBJECTIVE Therefore, we developed a Kinect-based task-specific virtual reality game, “Stomp Joy”, for post-stroke rehabilitation of the lower extremities. This study aim to assess its feasibility and clinical efficacy. METHODS We carried out a feasibility test for “Stomp Joy” within representative user groups. Then, a clinical efficacy experiment was performed with a randomized controlled trial of 22 patients with stroke who received ten sessions (2 weeks) of conventional physical therapy only (control group) or conventional physical therapy plus 30 min of “Stomp Joy” intervention (experimental group). The Fugl-Meyer Assessment for lower extremity (FMA-LE), Modified Bathel Index (MBI), Berg Balance Scale Score (BBS), Single leg supporting time (SLS Time), drop-out rate, and adverse effects were recorded. RESULTS The feasibility test showed “Stomp Joy” improved interest, pressure, perceived competence, value, and effort by using intrinsic motivation scale (IMI). The clinical efficacy trial showed that a significant time-group interaction effect for FMA-LE (p = 0.006), MBI (p = 0.001), BBS (p = 0.004), and SLS Time (p = 0.001). A significant time effect was found in FMA-LE (p = 0.001), MBI (p < 0.001), BBS (p < 0.001), and SLS Time (p = 0.025). These indicate an improvement in LE motor ability, basic activities of daily living, balance ability, and single-leg supporting time in both groups after 2 weeks of intervention. However, no significant effects were found of group on FMA-LE (p = 0.06), MBI (p = 0.76), and BBS (p = 0.38), while a significant group interaction was detected for SLS Time (p < 0.001). These results indicate that the experimental group significantly improved more in SLS Time than the control group. No one left the trial, and no adverse effects were reported. CONCLUSIONS “Stomp Joy” is an effective Kinect-base VR game for replacing part of the conventional physiotherapy time, achieving equally effective improvement in LE function among stroke survivors.