Rehabilitation Effects on Balance With Kinect for Xbox Virtual Reality Games
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      Virtual reality balance training has already been used in stroke rehabilitation, and previous
      studies supported that could improve balance ability. Although the treatment effects were
      supported in studies, there are still limitations in clinical intervention and the study
      power is not enough.

      Study will use Kinect for Xbox games for balance intervention. Investigators will recruit 60
      patients with chronic stroke from Shung-ho hospital clinical rehabilitation and randomly
      assign participants to "standard treatment plus virtual reality group" (N=30) and "standard
      treatment only group" (N=30). There are total 12 sessions (2 times weekly) for both groups.
      Investigators will assess subjects' ability for 3 times (pre- and post-intervention, follow
      up in post 3 month).Investigators will also record the pleasure scale and adverse event after
      every training session. Hypothesis is that Kinect for Xbox intervention can significantly
      improve subjects' balance ability, confidence of balance, ADL, and QOL compared to the
      conventional rehabilitation. It may help to develop a new clinical model of virtual reality
      training for patients with chronic stroke.
    

Detailed description: 
      Many stroke survivors suffered postural and balance problems. Decreased mobility limits their
      daily life activities. Virtual reality balance training has already been used in stroke
      rehabilitation, and previous studies supported that could improve balance ability. The
      mechanism is multi-sensory feedback and repeated practices that could facilitate motor
      learning and brain neuroplasticity. Compared to conventional rehabilitation, VR
      rehabilitation could increase subjects' motivation and pleasure. Although the treatment
      effects were supported in studies, there are still limitations in clinical intervention and
      the study power is not enough.

      The study will use Kinect for Xbox games for balance intervention. Kinect for Xbox doesn't
      need additional controller held by subjects and can detect the movement in real time to give
      subjects visual and auditory feedback immediately. Investigators will recruit 60 patients
      with chronic stroke from Shung-ho hospital clinical rehabilitation and randomly assign them
      to "standard treatment plus virtual reality group" (N=30) and "standard treatment only group"
      (N=30). There are total 12 sessions (2 times weekly) for both groups. Investigators will
      assess subjects' ability for 3 times (pre- and post-intervention, follow up in post 3 month).
      The outcome measures include Force plate, Functional reach test, Berg Balance Scale, Time up
      and go for balance evaluations, Modified barthel index for ADL ability, Activities-specific
      Balance Confidence scale for balance confidence, and Stroke Impact Scale for quality of life.
      Investigators will also record the pleasure scale and adverse event after every training
      session. Collected data will be analyzed with repeated measures 2-way analysis of variance
      (ANOVA), Turkey test post hoc and independent T sample test. Hypothesis is that Kinect for
      Xbox intervention can significantly improve subjects' balance ability, confidence of balance,
      ADL, and QOL compared to the conventional rehabilitation. It may help to develop a new
      clinical model of virtual reality training for patients with chronic stroke.
    

Intervention name(s): Virtual reality; Standard treatment
Intervention type(s): Behavioral; Behavioral
Intervention description(s): 12 training sessions (90 minutes a time, 2 times a week) IG:45 minute of Kinect for Xbox games and 45 minute of standard treatment.; CG: 90 minute of standard treatment. 12 training sessions (90 minutes a time, 2 times a week)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Rehabilitation; Virtual reality