Kaitlin Gardner, OTS January 24th, 2014

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Presentation transcript:

Kaitlin Gardner, OTS January 24th, 2014 Efficacy of Utilizing Rehabilitation Gaming Technologies in Occupational Therapy to Improve Upper Extremity Function & Occupational Performance Post CVA ASOT 2014 Vision in Action Conference Kaitlin Gardner, OTS January 24th, 2014

CEREBROVASCULAR ACCIDENT (CVA) According to the American Stroke Association, about 795,000 Americans each year suffer a new or recurrent stroke. Stroke is the leading cause of serious long term disability. Hemiparesis is the most common disability resulting from a stroke.

TECHNOLOGY ADVANCES

RESEARCH QUESTION For adults with upper extremity dysfunction secondary to CVA, will the use of rehabilitation gaming technologies in occupational therapy improve upper extremity function and occupation performance?

WHY ADDRESS THIS TOPIC? The prevalence of stroke and hemiparesis in the United States. Number of occupational therapists working with the CVA population. New trend of using gaming devices in therapy that requires evidence based research.

Wii-Hab Video

REHABILITATION GAMING TECHNOLOGIES

EVIDENCE BASED PRACTICE: PREPARATORY ACTIVITIES Utilizing Nintendo Wii with conventional therapy is shown to improve upper limb motor power (Joo, Yin, Xu, Thia, Chia, Kuah, & He, 2010). Gaming interventions that incorporate multiple repetitions of reaching toward targets is shown to improve ipsilateral reaching in individuals with chronic stroke (Combs, Finley, Henss, Himmler, Lapota, & Stillwell, 2012). Engagement in computer games while using a movement based game controller “CyWee Z” is shown to improve motor performance in adults with chronic stroke (Hijimans, Hale, Satherley, McMillan, & King, 2011).

EVIDENCE BASED PRACTICE: CLIENT FACTORS The Nintendo Wii was shown to be safe, feasible, and had some effectiveness in restoring upper extremity function in adults post-stroke (Saposnik, Teasell, Mamdani, Hall, Mcllroy, Cheung, . . . Bayley, 2010).

EVIDENCE BASED PRACTICE: OCCUPATION-BASED ACTIVITIES Rehabilitation Gaming Systems (RGS) is shown to improve recovery time and function in the upper extremity for adults in the acute phase of a stroke (Cameiraoa, Badiaa, Duartee, & Verschure, 2011). PlayStation EyeToy Games along with conventional therapy is shown to improve upper extremity function for activities of daily living in the sub-acute phase of a stroke (Yavuzer, Senel, Atay, & Stam, 2008).

EVIDENCE BASED PRACTICE: OCCUPATION-BASED ACTIVITIES The Nintendo Wii is shown to improve functional performance including both active and passive upper limb range of motion that translates into improvement with activities of daily living (Mouawad, Doust, Max, & McNulty, 2011). Utilizing robot-assisted therapy combined with 15 minutes of functional activity is shown to improve real world arm activity, quality of movement, and bimanual arm activity in the affected arm of individuals with chronic stroke (Liao, Wu, Hsieh, Lin, & Chang, 2011).

PATIENT PERCEPTION ON GAMING INTERVENTIONS

CONCLUSION The future of rehabilitation gaming technologies in occupational therapy. Overview The use of rehabilitation gaming technologies in occupational therapy improves upper extremity function and occupational performance for adults with upper extremity dysfunction secondary to CVA.

References Cameiraoa, M.S., Badiaa, S.B., Duartee, E., & Verschure, P. (2011). Virtual reality based rehabilitation speeds up functional recovery of the upper extremities after stroke: A randomized controlled pilot study in the acute phase of stroke using the rehabilitation gaming system. Restorative Neurology and Neuroscience, 29, 287–298. doi:10.3233/RNN-2011-0599 Combs, S.A., Finley, M.A., Henss, M., Himmler, S., Lapota, K., & Stillwell, D. (2012). Effects of a repetitive gaming intervention on upper extremity impairments and function in persons with chronic stroke: A preliminary study. Disability & Rehabilitation, 34, 1291-1298. doi: 10.3109/09638288.2011.641660 Hijmans, J.M., Hale, L.A., Satherley, J.A., McMillan, N.J., & King, M.J. (2011). Bilateral upper-limb rehabilitation after stroke using movement-based game controller. Journal of Rehabilitation Research & Development, 48, 1005-1014. doi: 10.1682/JRRD.2010.06.0109 Joo, L.Y., Yin, T.S., Xu, D., Thia, E., Chia, P.F., Kuah, C.W.K., & He, K.K. (2010). A feasibility study using interactive commercial off the shelf computer gaming in upper limb rehabilitation in patients after stroke. Journal of Rehabilitation Medicine, 42, 437-441. doi:10.2340/16501977-0528 Liao, W., Wu, C., Hsieh, Y., Lin, K., & Chang, W. (2011). Effects of robot-assisted upper limb rehabilitation on daily function and real-world arm activity in patients with chronic stroke: A randomized controlled trial. Clinical Rehabilitation, 26, 111-120. doi: 10.1177/0269215511416383

References Mouawad, M.R., Doust, C.G., Max, M.D., & McNulty, P.A. (2011). Wii-based movement therapy to promote improved upper extremity function post-stroke: A pilot study. Journal of Rehabilitation Medicine, 43, 527-533. doi: 10.2340/16501977-0816 Saposnik, G., Teasell, R., Mamdani, M., Hall, J., Mcllroy, W., Cheung, D., . . . Bayley, M. (2010). Effectiveness of virtual reality using Wii gaming technology in stroke rehabilitation: A pilot randomized clinical trial and proof of principle. Stroke, 41, 1477-1484. doi: 10.1161/STROKEAHA.110.584979 Yavuzer, G., Senel, A., Atay, M.B., & Stam, H.J. (2008). “Playstation eyetoy games” improve upper extremity-related motor functioning in sub-acute stroke: A randomized controlled clinical trial. European Journal of Physical and Rehabilitation Medicine, 44, 237-244. doi:10.2340/16501977-0528

QUESTIONS Email:Kgardner02@spalding.edu