Effects of Video-Game Based Therapy on Balance, Postural Control, Functionality, and Quality of Life of Patients with Subacute Stroke: A Randomized Controlled Trial

Purpose. To determine the effects of a structured protocol using commercial video games on balance, postural control, functionality, quality of life, and level of motivation in patients with subacute stroke. Methods. A randomized controlled trial was conducted. A control group (n = 25) received eight weeks of conventional rehabilitation consisting of five weekly sessions based on an approach for task-oriented motor training. The experimental group (n = 23) received conventional rehabilitation + video-game based therapy for eight weeks with commercial video games using the Xbox 360 degrees video games console and the Kinect (R) device with the same total treatment time for both groups. The Modified Rankin Scale, Barthel Index, Tinetti scale, Functional Reach test, Get Up and Go test, Baropodometry, EuroQoL 5D (EQ-5D), satisfaction, adherence, and motivation were used as outcome measures. Results. In the between-group comparison, statistically significant differences were observed in the Modified Rankin scores (p < 0.01), the Barthel Index (p = 0.05), the Tinetti gait assessment (p = 0.02), the Functional Reach test (p < 0.01), the Get Up and Go test (p = 0.05), the pain/discomfort dimension (p < 0.01), and anxiety/depression dimension (p < 0.01) of the EQ-5D and the VAS (visual analog scale) (p < 0.01) on the perceived health status based on the EQ-5D questionnaire. Regarding the scale of motivation, self-esteem, and adherence, statistically significant differences were achieved in motivation (p < 0.01), self-esteem (p < 0.01), and adherence (p < 0.01) variables. Conclusion. A protocol of semi-immersive video-game based therapy, combined with conventional therapy, may be effective for improving balance, functionality, quality of life, and motivation in patients with subacute stroke.