Game-based Robotic Training for Upper Limb Function after Stroke

Game-based robotic training (GBRT) can assist clinicians to provide high-dosage and high-repetition training to individuals with motor dysfunction after stroke. It has been used in clinical settings to improve upper limb (UL) function despite insufficient evidence to support its benefits. Therefore, the aim of this thesis was to explore the effectiveness of GBRT and the acceptability and perceptions of people with stroke and their family members (or carers) after a short protocol of GBRT. Two studies were conducted: a systematic review and a mixed-method study. The systematic review followed Cochrane recommendations. We performed a meta-analysis to pool the results of trials that investigated the effectiveness of GBRT. We found that GBRT, combined with CT, is superior to CT alone in improving UL function after a stroke. We also performed a subgroup analysis to investigate if types of robots and chronicity of stroke could influence the primary outcomes. The subgroup analysis showed that the effects of GBRT, particularly in UL function, could be optimised when utilized in chronic stroke using end-effector robotic devices. The second study in this thesis explored the experiences, satisfaction, and perceptions of the participants with stroke and their family members or carers. We also present pre-post preliminary data on the potential changes in UL function and quality of life after GBRT. Experiences and opinions of the participants with stroke about GBRT were collected using semi-structured interviews, and their satisfaction with the devices employed during the training was measured using a Likert-scale survey developed by the research team. Observations and perceptions of family members or carers were collected using an online survey via Redcap to provide insights on satisfaction with the intervention, potential observed changes in UL utilization on day-to-day activities and the mental outlook of the participants with stroke. Collectively, the findings of the thesis showed that GBRT was a well-accepted intervention among participants with a stroke that could increase their motivation and engagement towards highly repetitive training, especially during the chronic phase, where adherence to treatment tends to decrease. However, its effects were not superior to CT. Clinicians should consider employing GBRT as an adjunct to CT to facilitate the promotion of high-volume training and to optimize rehabilitation outcomes. Future research focused on comparing GBRT, and a dose-matched CT is required to provide certainty on the potential benefits of GBRT to improve UL function, and independence and reduce impairments after a stroke.

Author dc:creator

• Rivera II, Esminio Lacaden

Statement dc:rights

• info:eu-repo/semantics/openAccess
• The author owns the copyright in this thesis including all reproduction and reuse rights for the work. The work may not be altered without the permission of the copyright owner. Attribution is essential when quoting or paraphrasing from this thesis.
• © 2022 Esminio Lacaden Rivera II
• au.edu.uts.lib/cph

Language dc:language.iso

en_US

Handle dc:identifier.uri

http://hdl.handle.net/10453/170550

OAI identifier oai:identifier

oai:opus.lib.uts.edu.au:10453/170550