EVREST: Wii video games may assist in regaining motor function after stroke

International Stroke Conference 2010

Virtual reality technology using the Nintendo Wii gaming system may help patients who had stroke improve motor function and motion in their upper extremities, study results suggested.

Researchers for the EVREST study enrolled 22 stroke survivors (mean age, 61 years) and assigned them to either recreational therapy (n=11) or virtual reality therapy using the Wii (n=11). All patients participated in an intensive program of eight 60-minute sessions during two weeks, beginning approximately two months following stroke. Recreational activity included playing cards or the block-staking game Jenga, and virtual reality gaming included Wii Tennis or Wii Cooking Mama (which mimics movements such as cutting, slicing and shredding foods). The researchers aimed to evaluate the effects of the rehabilitation process using the two therapies on both fine and gross motor function.

According to the results, there were no adverse events reported in the Wii therapy group, with one reported adverse effect (dizziness or nausea) reported in the recreational activity group. The total time spent using the Wii technology was 364 minutes vs. 388 minutes spent by patients engaged in recreational therapy. Patients using Wii technology had significantly better performance at four weeks post-intervention in both Wolf motor function test scores and in grip strength.

After adjustment for age, baseline functional status and stroke severity, participants in the Wii group, on average performed about 30% better on the Wolf functional test than patients in the recreational therapy group. The researchers reported similar improvements from baseline in the box and blocks test scores, Stroke Impact Scale (SIS) hand function, SIS composite function, SIS perception of recovery and mean grip strength in both the Wii group and in the recreational group.

“This is the first randomized clinical trial aiming to identify or show that the use of virtual reality using Wii gaming technology seems to be safe, feasible and potentially effective in improving motor function after a stroke at two months,” Gustavo Saposnik, MD, director of the stroke outcomes research unit at St. Michael’s Hospital in Toronto, told Cardiology Today. “As far as we know, there are no other studies of stroke rehabilitation for improvement in motor function in the upper extremities using this technology.” – by Eric Raible

For more information:

Saposnik G. #LB P4. Presented at: International Stroke Conference; Feb. 24-26, 2010; San Antonio.

Patients can significantly improve after having stroke, but it takes a lot of practice and repetition. Gaming, such as that with the Wii, is a method to get patients to be engaged and repeatedly perform movement. With appropriate guidance from a therapist who directs the recovery and the gaming, it can be a way to practice movement and have fun. It can be an adjunct activity, and it has the added benefit of engaging other members of the family at the same time. As the researchers suggest, we need to have more studies to evaluate this approach more systematically, but it is already in nursing homes and rehabilitation facilities. In fact, the patients often want it.

– Pamela Duncan, PhD
Professor of Epidemiology
Duke Center for Clinical Health Policy Research, Durham, N.C.
American Stroke Association national spokesperson

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