Self-Directed Exergaming for Stroke Upper Limb Impairment Increases Exercise Dose Compared to Standard Care.
Michelle Broderick, Leeza Almedom, Etienne Burdet and 2 others
PMID 34449290WHAT IT FOUND
Stroke patients using a self-directed exergaming device doubled their daily upper limb exercise time and increased repetitions eightfold compared to standard therapy.
The device was safe and acceptable, but this small study proves feasibility, not functional recovery.
Key findings
01Patients using the device increased daily upper limb exercise duration twofold and repetition counts eightfold compared to conventional supervised therapy.
02The intervention was safe, with no adverse events or significant increases in pain and fatigue reported during the study period.
03Most participants (83%) were willing to be randomized in a future trial, indicating good acceptability of the self-directed device.
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
The study was a feasibility trial, not a randomized controlled trial, so the groups were not randomly allocated and may have differed in unmeasured ways. The sample size was small (30 intervention, 20 control), limiting the certainty of the findings. The study did not assess whether the increased exercise dose led to improved functional outcomes or recovery. Conduct was limited to a single centre in London, which may affect generalizability to other settings. A significant portion of screened patients (40%) were not recruited, primarily due to severe cognitive impairment, which limits applicability to the most impaired stroke survivors.
Declared interests
Two authors are co-founders of Gripable Ltd, a spin-out company related to the technology, though the study was funded by NIHR and Imperial College London.
The easy way to misread this
Do not assume that the increased exercise dose resulted in better patient outcomes. This study only measured whether the device was feasible and if it increased activity volume; it did not test efficacy or prove that patients recovered faster or more completely.