Xbox Kinect Training on Upper Limb Motor Function in Stroke Patients

.To determine the effects of Xbox Kinect training on upper limb motor function with conventional physical therapy in stroke patients

Physical therapy is the best adopted cure strategy in all over the world towards "excellence of life in post stroke patients." Physical therapy can be well-defined as "the health approach whose purpose is to make people able with good health conditions, undergoing or prone to undergo disability for the attainment and maintenance of optimum functioning in collaboration with the surroundings. The main objective of stroke physical therapy is to reduce disability and make people as healthy as to perform their daily life activities independently, do not relay on others and integrate into social life up to their own desires and expectations.

Significant reduction in impairments of upper limbs in stroke patient was noticed after goal oriented computer gaming. Motor function of upper limb has shown significant results after mirror therapy in comparison to conservative treatment.

Among new approaches used for rehabilitation, Robotic assisted therapy is also included. After neurological injury, the current technological advances ensure to the improvement of robotic devices to offer harmless and intensive recovery to the person with mild to moderate motor impairments. Robotic devices in physical therapy, offer more power, repeated, and task based interactive treatment session for impaired motor function of upper limb by providing patient's progress. So it's considered as the reliable source of rehabilitation. Rather like physical therapy exercises robotic devices can also be used to affect arm by high power and task specific movement. Repetitive movements are guided through a stereotyped procedure. If the movements are facilitated by external forces applied to the limb, highly repetitive stereotyped movements can be effective in stroke subjects.

A comparatively novel tool evolving in the field of physical rehabilitation is virtual reality based rehabilitation. Virtual reality (VR) can be well defined as an non natural and artificial computer generated reproduction or creation of a real life environment or condition permitting the user to navigate through interact with.

Virtual reality consists of computer hardware and software, provides a sort of interactive simulation to users which are almost near to real environment. Subjects participate in VR environment with pronounced motivation and enjoyable manner due to realistic visual sensory perception and thus simulates body movements of daily life.

There are two main types of VR. Non-immersive virtual reality and immersive virtual reality. In non-immersive environment user feels both the real and virtual environment. While in immersive, real world perception of subjects is being blocked and only virtual images are being seen.

The use of VR in physical rehabilitation programs can offer several benefits. First, environments and situations that are excessively dangerous, costly or impossible in real life can be computer-generated with the use of VR.

Second, these virtual environments (VEs) are fully controllable by therapists and researchers, giving the chance to bring real environments or situations.

Third, VE are artificially made and can therefore easily be changed, constructing the possibility to design modified environments and therapies.

Fourth, VR has the potential to increase patient 's enthusiasm by creating more exciting training environments causing in more repetitions and longer training duration, eventually improving patients' treatment compliance. VR interventions are advantageous for motor rehabilitation of the stroke survivors.

VR systems enhance movement intensity which is compulsory for the induction of neuronal plasticity. VR actually provides immediate feedback which allows users to interact with full attention and patient does so because he was determined to attain maximum scores. VR works upon the cortical reorganisation which is also facilitated by sensory visual and auditory feedback.There is an enormous literature supports for the use of Virtual reality based rehabilitation as compared with conventional therapies

Eligibility Criteria:
Inclusion Criteria:

* Stroke\>6 months
* No prior stroke
* Modified Ashworth scale\<4
* Patients able to follow instructions

Exclusion Criteria:

* No previous deformity
* Severe spastic hemiplegic
* Patients with visual and cognitive impairment
* Patients suffering from arm pain
* Severe illness