The Comparison of Virtual and Real Boxing Training in Hemiparetic Stroke Patients
Condition: Stroke; Hemiparesis
MeSH terms: Stroke; Paresis
Study type: Interventional

Summary: 
      The aim of this study is to compare the effects of virtual and real boxing training in
      addition to neurodevelopmental training on cognitive status, upper extremity functions,
      balance and activities of daily living in hemiparetic stroke patients.
    

Detailed description: 
      The use of computer systems has become a highly accepted approach in neurorehabilitation
      currently. Virtual reality (VR) is frequently used in different disease groups for this
      purpose. By using various VR equipment (sensors, balance board, control, etc.), exercises can
      be individualized to suit individual needs and aim to stimulate neural plasticity according
      to motor learning principles with repetitive activities.

      In recent years, it has been observed that boxing training (boxing therapy) in individuals
      with neurological diseases (e.g. Parkinson's disease and stroke) gives positive results. It
      has been shown in the literature there are short and long-term improvement in daily life
      activities, quality of life, balance and gait functions after boxing training in patients
      with Parkinson' disease despite the progressive nature of Parkinson's disease. Additionally
      it was found that boxing program in sitting has positive effects on upper extremity
      functions, balance, walking and quality of life in stroke patients. In the literature, there
      were no studies comparing virtual and boxing therapy in stroke patients. Therefore, the aim
      of this study is to compare the effects of virtual and real boxing training in addition to
      neurodevelopmental training (NDT) on cognitive status, upper extremity functions, balance and
      activities of daily living in hemiparetic stroke patients.

      Patients who have had a stroke for the first time with hemiparesis, who are between the ages
      of 18-70, who has Mini Mental Test score above 23, whose functional level is less than 4
      according to the Modified Rankin Scale, who has upper extremity spasticity lower than 3 on
      Modified Ashworth Scale will be included in this study. In case of hypertension which may
      prevent rehabilitation, heart disease, subluxation and fracture at the shoulder, visual
      impairment, limitation in passive normal joint movement in hemiplegic side, botulinum toxin
      administration or surgical operation in the last 6 months patients will not be excluded.

      All the patients will be measured with Addenbrooke's Cognitive Assessment (ACA), Minnesota
      Hand Skill Test, Wolf Motor Function Test (WMFT), Fullerton Advanced Balance Scale (FAB),
      Frenchay Activity Index (FAI) and video boxing analysis of punching.The measurements will be
      made at the beginning of the treatment (0 weeks) and at the end of the treatment (8 weeks).

      NDT approaches consist of upper extremity facilitation techniques and activities in
      accordance with the patient's functional level, weight transfer and walking exercises to
      increase sitting and standing balance, mat exercises with the same purpose considering the
      functional level for each patient. In the real boxing (RB) group in addition to the NDT
      program, real boxing training will be given. Accordingly, the physiotherapist and the patient
      will wear boxing gloves and the patients will punch the physiotherapist's glove with a
      pre-specified treatment protocol. Resistance and frequencies between levels will be increased
      by the physiotherapist as the sessions progress. The RB group will have 30 minutes of real
      boxing training for 3 sessions per week for 8 weeks. In the virtual boxing (VB) group, in
      addition to the NDT program, virtual boxing training will be given by using Kinect Xbox
      Boxing. For the VB group, virtual boxing training will be held for 3 weeks 30 minutes a week
      for 8 weeks.
    

Intervention name(s): real boxing training; virtual boxing training
Intervention type(s): Other; Other
Intervention description(s): In the real boxing (RB) group in addition to the NDT program, real boxing training will be given. Accordingly, the physiotherapist and the patient will wear boxing gloves and the patients will punch the physiotherapist's glove with a pre-specified treatment protocol. Resistance and frequencies between levels will be increased by the physiotherapist as the sessions progress. The RB group will have 30 minutes of real boxing training for 3 sessions per week for 8 weeks.; In the virtual boxing (VB) group, in addition to the NDT program, virtual boxing training will be given by using Kinect Xbox Boxing. For the VB group, virtual boxing training will be held for 3 weeks 30 minutes a week for 8 weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized controlled study
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: virtual reality; boxing; upper extremity function; cognitive function; balance