Article

Decreased weight bearing on the affected lower limb and poor weight
shifting are common after a stroke occurs. The 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 its
clinical use for patients affected by stroke is limited.
OBJECTIVE: To
investigate the feasibility and potential efficacy of the Tetrax 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 also received 20 minutes of 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, and Forward Reach tests. We used percentage change
(post-training score - pretraining score/pretraining score) to quantify the
intervention effects. Mann-Whitney U tests were used to analyze differences in
percentage of change between groups. RESULTS: A total of 14 participants were
assigned to the IG, and 13 were assigned to the CG; 12 participants in the IG and
11 in the 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. With use of 5-point Likert scales,
participants rated their enjoyment of Tetrax games as 4.33 +/- 0.78, their
motivation as 4.17 +/- 1.03, and perceived helpfulness as 4.25 +/- 0.97. The IG
demonstrated a significantly greater improvement in reaction time (P = .002),
proprioception (P < .001), symmetric weight bearing (P = .027), Timed Up and Go
(P < .001), and Forward Reach (P < .001) compared with the CG. CONCLUSIONS: Using
Tetrax biofeedback video games for balance training is a feasible adjunctive
program that may augment conventional therapy in persons affected by chronic
hemiplegic stroke.
LEVEL OF EVIDENCE: II.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.
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Langue : ANGLAIS