Home-based guidance training system with interactive visual feedback using kinect on stroke survivors with moderate to severe motor impairment.
Hsuan-Yu Lu, Xiaoyi Wang, Chengpeng Hu and 2 others
PMID 39438877WHAT IT FOUND
After 800 min of therapist-guided home Kinect training, 12 moderate-to-severe stroke survivors improved Fugl-Meyer scores and joint range of motion, but Berg Balance Scale did not improve.
Key findings
01After 800 min of home-based guidance training, Fugl-Meyer upper limb scores improved from 31.00 to 43.58 and lower limb scores from 18.08 to 24.08, with significant total-score improvement.
02Active range of motion improved significantly in hip abduction, hip flexion, knee flexion, shoulder flexion, and shoulder abduction; hip abduction, shoulder flexion, and shoulder abduction reached the upper limit of functional range of motion.
03The Berg Balance Scale did not improve (pre 43.25, post 46.00, p 0.137), although right/left and superior/inferior center-of-mass displacements increased during lateral weight shifting.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 12 patients were studied, all in one group with no control, randomisation, or blinding, so improvement cannot be compared with usual recovery or usual therapy. Patients had to be able to follow instructions and train independently, so results do not apply to stroke survivors with severe cognitive, behavioural, or communication barriers. All participants received therapist-prescribed core and optional exercises, real-time feedback, and therapist updates based on weekly reports; the paper cannot separate the effect of any single component. Kinect joint-angle measurements had mean root-mean-square error 3 to 17 degrees compared with Vicon, so some kinematic changes may reflect measurement error. Post-training assessment was within 1 week, so durability beyond the immediate end of training is unknown. Berg Balance Scale and several balance ellipse measures were not significant, despite some center-of-mass displacement changes.
The easy way to misread this
Do not conclude that the Kinect system alone caused these gains. The study had no control group, only 12 participants, and therapists selected and updated exercises while giving real-time feedback, so training volume, exercise selection, feedback, and usual recovery cannot be separated.