09 September 2011

Video games help stroke recovery

Video gamers might face some surprising additions to their ranks if studies of virtual reality systems in stroke rehab patients can be confirmed.


Video gamers might face some surprising additions to their ranks if studies of virtual reality systems in stroke rehab patients can be confirmed.

A new meta-analysis found virtual reality could help stroke patients regain some physical function in the short term and perform daily activities better than conventional stroke therapy.

Still, said Judith Deutsch, one of the authors of the review and a physical therapy researcher at the University of Medicine and Dentistry of New Jersey in Newark, "I'm not sure we're looking at it replacing conventional therapy." Instead, she suggested that using virtual reality video games could complement other types of rehab.

"You can make it engaging, and you can have somebody potentially work at a high intensity and for longer than they might if they didn't have the stimulation of the game and the virtual environment," she told Reuters Health.

Research limited

With some virtual reality programs, patients can practice dressing themselves, shopping in a supermarket, or driving their car until they improve enough to do those activities in the real world. Or, they can play games that require repeated muscle movements and improve strength.

But some experts say it's too soon for stroke survivors to start treatment with virtual reality, noting that the research is promising but still limited. And in most of the studies so far, scientists tested customised systems, not off-the-shelf games.

Taking stock of the current medical evidence, Deutsch's research team pooled the results of 19 studies that compared virtual reality rehab with conventional physical and occupational therapy or no treatment in a total of 565 stroke patients.

The studies showed that patients who used virtual reality had better arm function than after conventional therapy, and also tended to improve more on basic daily activities, such as showering and dressing.

Larger studies needed

Virtual reality didn't seem to improve hand strength or walking speed, however, and there wasn't enough data to examine its effect on thinking and memory skills.

Most patients in the studies were relatively young side, and the trials were limited by their small size, Deutsch and colleagues note in their report, published by The Cochrane Library.

"At the end of the day, what it means is these studies are showing a potential benefit and a trend," said Dr Gustavo Saposnik, who heads the Stroke Outcomes Research Unit at St Michael's Hospital in Toronto. He was not involved in the review.

Dr Saposnik told Reuters Health that larger studies are needed. At this point, he said, "We are not recommending any of our patients to undergo or to try virtual reality outside of a clinical study."

Benefits still unclear

But it's promising, he added, that virtual reality can fulfil some of the basic concepts in stroke rehab, including repetition of specific activities at varying intensity levels.

The researchers noticed improvement over conventional therapy starting after about 15 hours of virtual reality, but said it's unclear if the benefits would hold up over more than a few months.

With investigators increasingly focusing on readily-available gaming systems such as the Wii and Kinect for rehab instead of more expensive custom-made devices, Deutsch said that doctors and physical therapists can expect to know a lot more about virtual reality soon.

"There's a lot of cool stuff that's going to happen in the next couple years," she said.

(Reuters Health, September 2011) 

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