Video Game Rehabilitation for Outpatient Stroke (VIGoROUS): protocol for a multi-center comparative effectiveness trial of in-home gamified constraint-induced movement therapy for rehabilitation of chronic upper extremity hemiparesis
Abstract Background Constraint-Induced Movement therapy (CI therapy) is shown to reduce disability, increase use of the more affected arm/hand, and promote brain plasticity for individuals with upper extremity hemiparesis post-stroke. Randomized controlled trials consistently demonstrate that CI the...
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doaj-be408ca25ed040f085cbdca26405df222020-11-24T21:47:44ZengBMCBMC Neurology1471-23772017-06-0117111810.1186/s12883-017-0888-0Video Game Rehabilitation for Outpatient Stroke (VIGoROUS): protocol for a multi-center comparative effectiveness trial of in-home gamified constraint-induced movement therapy for rehabilitation of chronic upper extremity hemiparesisLynne V. Gauthier0Chelsea Kane1Alexandra Borstad2Nancy Strahl3Gitendra Uswatte4Edward Taub5David Morris6Alli Hall7Melissa Arakelian8Victor Mark9The Ohio State University, Department of Physical Medicine and Rehabilitation, Division of Rehabilitation PsychologyThe Ohio State University, Department of Physical Medicine and Rehabilitation, Division of Rehabilitation PsychologyDepartment of Physical Therapy, College of St. ScholasticaProvidence Medford Medical CenterDepartment of Psychology; UAB Department of Psychology, University of Alabama at BirminghamDepartment of Psychology; UAB Department of Psychology, University of Alabama at BirminghamDepartment of Physical Therapy; UAB Department of Physical Therapy, University of Alabama at BirminghamThe Ohio State University, Department of Physical Medicine and Rehabilitation, Division of Rehabilitation PsychologyProvidence Medford Medical CenterDepartment of Psychology; UAB Department of Psychology, University of Alabama at BirminghamAbstract Background Constraint-Induced Movement therapy (CI therapy) is shown to reduce disability, increase use of the more affected arm/hand, and promote brain plasticity for individuals with upper extremity hemiparesis post-stroke. Randomized controlled trials consistently demonstrate that CI therapy is superior to other rehabilitation paradigms, yet it is available to only a small minority of the estimated 1.2 million chronic stroke survivors with upper extremity disability. The current study aims to establish the comparative effectiveness of a novel, patient-centered approach to rehabilitation utilizing newly developed, inexpensive, and commercially available gaming technology to disseminate CI therapy to underserved individuals. Video game delivery of CI therapy will be compared against traditional clinic-based CI therapy and standard upper extremity rehabilitation. Additionally, individual factors that differentially influence response to one treatment versus another will be examined. Methods This protocol outlines a multi-site, randomized controlled trial with parallel group design. Two hundred twenty four adults with chronic hemiparesis post-stroke will be recruited at four sites. Participants are randomized to one of four study groups: (1) traditional clinic-based CI therapy, (2) therapist-as-consultant video game CI therapy, (3) therapist-as-consultant video game CI therapy with additional therapist contact via telerehabilitation/video consultation, and (4) standard upper extremity rehabilitation. After 6-month follow-up, individuals assigned to the standard upper extremity rehabilitation condition crossover to stand-alone video game CI therapy preceded by a therapist consultation. All interventions are delivered over a period of three weeks. Primary outcome measures include motor improvement as measured by the Wolf Motor Function Test (WMFT), quality of arm use for daily activities as measured by Motor Activity Log (MAL), and quality of life as measured by the Quality of Life in Neurological Disorders (NeuroQOL). Discussion This multi-site RCT is designed to determine comparative effectiveness of in-home technology-based delivery of CI therapy versus standard upper extremity rehabilitation and in-clinic CI therapy. The study design also enables evaluation of the effect of therapist contact time on treatment outcomes within a therapist-as-consultant model of gaming and technology-based rehabilitation. Trial registration Clinicaltrials.gov, NCT02631850 .http://link.springer.com/article/10.1186/s12883-017-0888-0ProtocolResearch designRandomized controlled trialCI therapyConstraint-induced movement therapyRehabilitation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lynne V. Gauthier Chelsea Kane Alexandra Borstad Nancy Strahl Gitendra Uswatte Edward Taub David Morris Alli Hall Melissa Arakelian Victor Mark |
spellingShingle |
Lynne V. Gauthier Chelsea Kane Alexandra Borstad Nancy Strahl Gitendra Uswatte Edward Taub David Morris Alli Hall Melissa Arakelian Victor Mark Video Game Rehabilitation for Outpatient Stroke (VIGoROUS): protocol for a multi-center comparative effectiveness trial of in-home gamified constraint-induced movement therapy for rehabilitation of chronic upper extremity hemiparesis BMC Neurology Protocol Research design Randomized controlled trial CI therapy Constraint-induced movement therapy Rehabilitation |
author_facet |
Lynne V. Gauthier Chelsea Kane Alexandra Borstad Nancy Strahl Gitendra Uswatte Edward Taub David Morris Alli Hall Melissa Arakelian Victor Mark |
author_sort |
Lynne V. Gauthier |
title |
Video Game Rehabilitation for Outpatient Stroke (VIGoROUS): protocol for a multi-center comparative effectiveness trial of in-home gamified constraint-induced movement therapy for rehabilitation of chronic upper extremity hemiparesis |
title_short |
Video Game Rehabilitation for Outpatient Stroke (VIGoROUS): protocol for a multi-center comparative effectiveness trial of in-home gamified constraint-induced movement therapy for rehabilitation of chronic upper extremity hemiparesis |
title_full |
Video Game Rehabilitation for Outpatient Stroke (VIGoROUS): protocol for a multi-center comparative effectiveness trial of in-home gamified constraint-induced movement therapy for rehabilitation of chronic upper extremity hemiparesis |
title_fullStr |
Video Game Rehabilitation for Outpatient Stroke (VIGoROUS): protocol for a multi-center comparative effectiveness trial of in-home gamified constraint-induced movement therapy for rehabilitation of chronic upper extremity hemiparesis |
title_full_unstemmed |
Video Game Rehabilitation for Outpatient Stroke (VIGoROUS): protocol for a multi-center comparative effectiveness trial of in-home gamified constraint-induced movement therapy for rehabilitation of chronic upper extremity hemiparesis |
title_sort |
video game rehabilitation for outpatient stroke (vigorous): protocol for a multi-center comparative effectiveness trial of in-home gamified constraint-induced movement therapy for rehabilitation of chronic upper extremity hemiparesis |
publisher |
BMC |
series |
BMC Neurology |
issn |
1471-2377 |
publishDate |
2017-06-01 |
description |
Abstract Background Constraint-Induced Movement therapy (CI therapy) is shown to reduce disability, increase use of the more affected arm/hand, and promote brain plasticity for individuals with upper extremity hemiparesis post-stroke. Randomized controlled trials consistently demonstrate that CI therapy is superior to other rehabilitation paradigms, yet it is available to only a small minority of the estimated 1.2 million chronic stroke survivors with upper extremity disability. The current study aims to establish the comparative effectiveness of a novel, patient-centered approach to rehabilitation utilizing newly developed, inexpensive, and commercially available gaming technology to disseminate CI therapy to underserved individuals. Video game delivery of CI therapy will be compared against traditional clinic-based CI therapy and standard upper extremity rehabilitation. Additionally, individual factors that differentially influence response to one treatment versus another will be examined. Methods This protocol outlines a multi-site, randomized controlled trial with parallel group design. Two hundred twenty four adults with chronic hemiparesis post-stroke will be recruited at four sites. Participants are randomized to one of four study groups: (1) traditional clinic-based CI therapy, (2) therapist-as-consultant video game CI therapy, (3) therapist-as-consultant video game CI therapy with additional therapist contact via telerehabilitation/video consultation, and (4) standard upper extremity rehabilitation. After 6-month follow-up, individuals assigned to the standard upper extremity rehabilitation condition crossover to stand-alone video game CI therapy preceded by a therapist consultation. All interventions are delivered over a period of three weeks. Primary outcome measures include motor improvement as measured by the Wolf Motor Function Test (WMFT), quality of arm use for daily activities as measured by Motor Activity Log (MAL), and quality of life as measured by the Quality of Life in Neurological Disorders (NeuroQOL). Discussion This multi-site RCT is designed to determine comparative effectiveness of in-home technology-based delivery of CI therapy versus standard upper extremity rehabilitation and in-clinic CI therapy. The study design also enables evaluation of the effect of therapist contact time on treatment outcomes within a therapist-as-consultant model of gaming and technology-based rehabilitation. Trial registration Clinicaltrials.gov, NCT02631850 . |
topic |
Protocol Research design Randomized controlled trial CI therapy Constraint-induced movement therapy Rehabilitation |
url |
http://link.springer.com/article/10.1186/s12883-017-0888-0 |
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