PM R. 2016 Mar 8. pii: S1934-1482(16)00160-X. doi: 10.1016/j.pmrj.2016.02.009. [Epub ahead of print]

Feasibility of Using TetraxTM Biofeedback Video-games for Balance Training in Patients with Chronic Hemiplegic Stroke.

Hung JW1, Yu MY2, Chang KC3, Lee HC4, Hsieh YW2, Chen PC2.

Abstract

BACKGROUND:

Decreased weight bearing on the affected lower limb and poor weight shifting are common post-stroke. Tetrax™ biofeedback system is a center-of-pressure controlled video-game system designed for patients with balance deficits. Although it is a commercial product, information about the clinical use for patients with stroke is limited.

OBJECTIVE:

To investigate the feasibility and potential efficacy of the TetraxTM biofeedback system for balance training in patients with chronic stroke.

DESIGN:

Feasibility study SETTING: Rehabilitation department of a medical center.

PARTICIPANTS:

Participants who had sustained a hemiplegic stroke at least 6 months prior to enrollment but were still able to stand independently for more than 5 minutes.

METHODS:

Participants were randomly assigned to an intervention group (IG) or control group (CG). All participants received conventional rehabilitation training. The IG received 20 minutes additional exposure to Tetrax biofeedback games controlled by change in center of pressure 3 times a week for 6 weeks.

MAIN OUTCOME MEASUREMENTS:

The primary outcome was feasibility, addressed by adherence, safety and satisfaction. The secondary outcome was efficacy, which was evaluated by the subtests of physiological profile assessment, posturography, Timed Up and Go (TUAG), and forward reach tests. We used percentage change, (post-training score- pre-training score)/ pre-training score, to quantify the intervention effects. Mann-Whitney U tests were used to analyze differences in percentage of change between groups.

RESULTS:

There were 14 participants assigned to IG and 13 to CG; 12 in IG and 11 in CG completed the study. In the IG group, those who completed the 6-week intervention attended 89.5% of planned sessions. No major adverse events or falls occurred within the intervention sessions. By using 5-point Likert scales, participants rated their enjoyment of Tetrax games as 4.33±0.78, motivation 4.17±1.03, and perceived helpfulness 4.25±0.97. The IG demonstrated a significantly greater improvement in reaction time (P = .002), proprioception (P < .001), symmetric weight bearing (P = .027), TUAG (P < .001) and forward reach (P < .001) as compared with CG.

CONCLUSIONS:

Using TetraxTM biofeedback video games for balance training is a feasible adjunctive program, which may augment conventional therapy in people with chronic hemiplegic stroke.

Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

PMID:

26968609