Authors: (including presenting author): :
Lau KY(1), Ng HM(1), Wong CY(1), Chan CL(1), Chan WC(1), Wong ST(1)
Affiliation: :
(1)Physiotherapy Department, Haven of Hope Hospital
Keyword 1: :
Gamified, Gamification
Keyword 2: :
Upper Limb Robotic-Assisted Therapy (RAT)
Keyword 4: :
Rehabilitation
Introduction: :
Stroke is a major cause of disability worldwide. More than half of stroke survivors present with upper limb impairments even in the chronic stage. Upper limb RAT incorporating gamification represents an innovative approach developed to deliver intensive rehabilitation for upper limb extremity. It consists of a weight support motorized arm orthosis to provide assist-as-needed guidance for upper limb functional movements. While patients engage in exergaming, the game is directly driven by movements of the affected upper limb. The design can motivate patients to actively participate in therapy and encourage them to achieve the intended range of motion. Progression can be made by increasing the difficulties of game, expanding the required range of movements and reducing the level of upper limb weight support.
Objectives: :
To evaluate the effectiveness of gamified upper limb RAT on hemi-paretic upper extremity function and hand grip strength outcomes in stroke rehabilitation.
Methodology: :
A single-group pre-post design was adopted. 27 stroke survivors with average age of 61 (SD = 12) were recruited in our hospital from August 2023 to December 2025. Exclusion criteria included significant cognitive impairment, severe vision deficits, completely flaccid upper limb or inability to tolerate prolonged sitting. In addition to conventional rehabilitation program, gamified RAT intervention was provided to these participants. Each session lasted approximately 30 minutes. The outcomes were (1) total score of Shortened Fugl-Meyer Assessment Upper Extremity Scale (S-FMA-UE total), which includes 6 items with a maximum score of 12 and (2) Paretic Hand Grip (PHG) in kilograms of force (KgF). Changes in S-FMA-UE total was analyzed using the Wilcoxon signed rank test, while changes in PHG was evaluated with the Paired t-test.
Result & Outcome: :
Each subject received 22 treatment sessions on average, 2-3 times per week. Significant improvements were observed in both outcome measures. The median of S-FMA-UE total increased from 6 to 10 (p < 0.0001). The PHG also demonstrated significant improvement (mean difference = 5.39kgF; 95% CI -7.36 -3.43; p < 0.0001). The addition of gamified RAT to conventional physiotherapy produced favorable improvements in paretic upper limb function and hand grip strength among stroke survivors. This intervention can be regarded as a valuable option for upper limb rehabilitation in individuals following stroke.
