Use of an EMG-Controlled Game as a Therapeutic Tool to Retrain Hand Muscle Activation Patterns Following Stroke: A Pilot Study.

Only 20 people took part, all from one research database at a single centre, and the authors themselves say the effect should be read with caution. There was no usual-care or no-treatment group, so the improvements could reflect attention, motivation or simply practising with an intensive schedule rather than the game itself. Training lasted three weeks. Nobody has tested longer periods. No functional task practice was included in the therapy, so it is unknown whether this training improves what people actually do with their hand. Bilateral function was never measured, so nothing can be said about whether bilateral training helps two-handed activity. The only clinical measure that changed, the WMFT Functional Abilities score, moved by 0.23 out of 5, which is below the minimum clinically important difference of 1.0 to 1.2 for that score. The main test was a cursor task on a screen, not a task the person does in daily life. Both groups improved, so the study cannot show which approach suits whom; the authors suggest bilateral training might matter more for people with greater impairment, but that is untested here. One participant with an extreme path length value was removed from that analysis.

The authors state that all of them report no conflict of interest. The article text does not describe who funded the work or any sponsor role.

Do not read the faster cursor times as proof that hand function improved. This was a 20-person pilot with no usual-care control, and the only clinical measure that moved rose by 0.23 out of 5, which is below the minimum clinically important difference of 1.0 to 1.2. Do not conclude that bilateral training is better than unilateral training either. The two groups did not differ.