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StrokeNCT02553993

Comparing the Cognitive Effects of Two Exergame Training and Traditional Training in Patients With Chronic Stroke

A study testing Wii Fit(30 Mins), Tetrax biofeedback(30 Mins) and Conventional weight-shifting(30 Mins) in people with Stroke, run by Chang Gung Memorial Hospital at 1 site in Taiwan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The objective of this study was to: compare the training and maintenance effects of 3 balance training programs (2 kinds of exergame systems and 1 conventional weight-shifting training program) on cognitive function of subjects with chronic stroke. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Stroke
What is being tested?
Wii Fit(30 Mins), Tetrax biofeedback(30 Mins) and Conventional weight-shifting(30 Mins)
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
43 participants
Where
1 siteTaiwan
Study dates
Sep 2013to Mar 2015
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Post-stroke duration of at least 6 months
  • Ability to understand verbal instructions and learn
  • Adequate visual acuity (with appropriate correction, if necessary)
  • Ability to walk independently with or without device

Who cannot join

  • Bilateral hemispheric
  • Cerebellar lesions
  • Aphasia
  • Significant visual field deficits
  • Hemineglect
  • History of orthopedic
  • Other neurological diseases
  • Medical conditions that would prevent adherence to the exercise protocol

Trial locations and contacts

1 site in 1 country.

Taiwan1 site
  • Department of Rehabilitation, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan

    Kaohsiung, Taiwan, 833

Other trials in Taiwan

About this study

Official title: Comparing the Cognitive Effects of Two Exergame Balance Training Systems and Traditional Weight Shifting Training in Patients With Chronic Stroke

The objective of this study was to: compare the training and maintenance effects of 3 balance training programs (2 kinds of exergame systems and 1 conventional weight-shifting training program) on cognitive function of subjects with chronic stroke.

Read the detailed description

The objective of this study was to: compare the training and maintenance effects of 3 balance training programs (2 kinds of exergame systems and 1 conventional weight-shifting training program) on cognitive function of subjects with chronic stroke. We hypothesized that the exergaming program using weight shifting as game controller is better than the weight shifting only program. The investigators further hypothesized that exergames designed for entertainment (such as Wii Fit) are more beneficial than exergames for rehabilitation purpose (such as Tetrax biofeedback) in gain of cognition function for patients with chronic stroke.

Conditions
Stroke
Being tested
Wii Fit(30 Mins), Tetrax biofeedback(30 Mins), Conventional weight-shifting(30 Mins)
Keywords
Stroke, Cognition, Exergames, Weight shifting, Balance, Rehabilitation
Medical subject headings
Stroke

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Wii Fit(30 Mins)Device

    Receive Wi Fit games training for 30 minutes. There are 2 sections for 1 week; the intervention period will be 12 weeks.

  • Tetrax biofeedback(30 Mins)Device

    Receive Tetrax biofeedback games training for 30 minutes. There are 2 sections for 1 week; the intervention period will be 12 weeks.

  • Conventional weight-shifting(30 Mins)Other

    Receive weight-shifting exercise training for 30 minutes. There are 2 sections for 1 week; the intervention period will be 12 weeks.

Study groups in NCT02553993
Study groupRoleWhat they receive
Wii FitExperimentalThe Wii Fit training was conducted using the Wii Fit bundle from Nintendo, which consists of the Wii console, a Wii Balance Board, and the Wii Fit Plus balance game disc. The Wii balance board has 4 transducers, which could assess the player's force distribution and resultant movements in the center of pressure (COP). The participants stood on the board and used the change of COP to play the games. Five games (Tilt, Soccer Heading, Balance Bubble, Penguin Slide, and Perfect 10) were selected from the Wii Fit Plus package based on the motor demand of these games. The major movement patterns to play the games included right-left weight shifting and front-back weight shifting.
Receives: Device: Wii Fit(30 Mins)
Tetrax biofeedbackExperimentalThe Tetrax biofeedback games aimed at postural rehabilitation to help patients or athletes improve their balance abilities. There were 11 games in Tetrax system; 8 games (Speedtrack, Catch, Skyball, Gotcha, Speedball, Tag, Freeze, Immobilizer) were chosen based on the same principle as those used for choosing Wii Fit games. The parameters of games' difficulties included target size and/or speed of target movement, which could be adjusted according to the patients' ability. For the Wii Fit or Tetrax group, at each session, the supervising therapist chose 3 to 5 games for participants according to their ability, needs, and favorites.
Receives: Device: Tetrax biofeedback(30 Mins)
Conventional weight-shiftingPlacebo comparatorThe conventional weight-shifting exercise group performed balance exercises with the similar movements and time required by the 2 exergame systems but without video games. By using occupational activities, participants did weight shifting in the sagittal and frontal planes. The investigators also used a balance board (Reebok Core board) for multi-directional weight shifting training
Receives: Other: Conventional weight-shifting(30 Mins)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from Baseline in Cognitive Abilities Screening Instrument Scale Chinese version (CASI C-2.0)

    The CASI C-2.0 consists of 20 item sets, which can be divided into 9 domains, including long-term memory, short-term memory, attention, concentration or mental manipulation, orientation, abstraction/judgment, language, visual construction, and category fluency. The CASI scores range from 0 to 100, with higher scores indicating better cognitive performance.

    Measured: Subjects will be assesed at 12 weeks and 24 weeks

Secondary outcomes (10)
  1. Change from Baseline in The Stroop test

    The Stroop test requires selective attention, response inhibition, and working memory. The Stroop score ranges from 0 to 63, with higher scores indicating better performance.

    Measured: Subjects will be assesed at 12 weeks and 24 weeks

  2. Change from Baseline in The modified Trail Making Test(TMT)

    The modified Trail Making Test (TMT) requires visual scanning, visuo-motor tracking, divided attention, and cognitive flexibility. The shorter time to complete the test means better performance.

    Measured: Subjects will be assesed at 12 weeks and 24 weeks

  3. Change from Baseline in The digit backward performance

    The digit backward performance requires attention and working memory. The scores range from 2 to 7 higher scores indicating better performance.

    Measured: Subjects will be assesed at 12 weeks and 24 weeks

  4. Change from Baseline in Physiological profile assessment(PPA)

    The PPA is a validated battery of sensorimotor measurements used to identify those subjects at risk of falling.

    Measured: Subjects will be assesed at 12 weeks and 24 weeks

  5. Change from Baseline in The 10m walking test

    The 10m WT is a reliable, valid, and responsive measure for sub-acute stroke. Walking speed will be assessed by self-selected gait speed over 10 m. The shorter time it takes is indicating better performance.

    Measured: Subjects will be assesed at 12 weeks and 24 weeks

  6. Change from Baseline in Tetrax balance system

    Tetrax balance system will be used to assess static standing balance. The lower risk scores is indicating better performance.

    Measured: Subjects will be assesed at 12 weeks and 24 weeks

  7. Change from Baseline in Timed Up and Go (TUG) test

    Timed Up and Go (TUG) test will be used to assessed Dynamic balance function. The shorter time it take means better performance.

    Measured: Subjects will be assesed at 12 weeks and 24 weeks

  8. Change from Baseline in The Frenchay Activities Index (FAI)

    The Frenchay Activities Index (FAI) was used as a measure of subjects' participation level. The 15-item index records the frequency of performing social activities as well as more complex activities of daily living (eg, domestic chores, outdoor mobility, leisure, gainful work). The FAI item score is based on the frequency with which an activity was performed, and ranges from 0 (low frequency) to 3 (high frequency). Ten items concern the past 3 months and 5 items concern the past 6 months. The FAI total score is the sum of item scores, and ranges from 0 (inactive) to 45 (highly active).

    Measured: Subjects will be assesed at 12 weeks and 24 weeks

  9. Change from Baseline in Stroke Impact Scale

    The Stroke Impact Scale (SIS) is a 59-item self-reported scale with good reliability, validity, and sensitivity to change. The SIS consists of 8 functional domains: strength, memory, emotion, communication, ADL/ instrumental ADL (IADL), mobility, hand function, and participation. The overall SIS score represents the average score of the 8 domains. Each item score ranges from 1 to 5. Each domain score has a range of 0 to 100 and is computed by using the following equation: Score =[(Mean - 1)/(5 - 1)] × 100. In this equation, the score is that of a particular domain, and the mean is the average of the item scores within that domain. A higher score on an item denotes better performance.

    Measured: Subjects will be assesed at 12 weeks and 24 weeks

  10. Change from Baseline in Physical Activity Enjoyment Scale (PACES)

    The PACES is a 18-item and 7-point self-reported scale, and the higher score has more enjoyment of the training.

    Measured: Subjects will be assesed at 12 weeks and 24 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Sep 2015 (estimated)
  2. Study startSep 2013
  3. Primary completionMar 2015
  4. Study completionMar 2015

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
43 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02553993
Sponsor's protocol ID
CMRPG8C0261
Status last verified
Sep 2015
First submitted
14 Sep 2015
Last updated
8 Jan 2016
Results posted
No
Data monitoring committee
Yes

Publications

  • Zinn S, Dudley TK, Bosworth HB, Hoenig HM, Duncan PW, Horner RD. The effect of poststroke cognitive impairment on rehabilitation process and functional outcome. Arch Phys Med Rehabil. 2004 Jul;85(7):1084-90. doi: 10.1016/j.apmr.2003.10.022.

    PubMed 15241754
  • Mok VC, Wong A, Lam WW, Fan YH, Tang WK, Kwok T, Hui AC, Wong KS. Cognitive impairment and functional outcome after stroke associated with small vessel disease. J Neurol Neurosurg Psychiatry. 2004 Apr;75(4):560-6. doi: 10.1136/jnnp.2003.015107.

    PubMed 15026497
  • Nys GM, van Zandvoort MJ, de Kort PL, Jansen BP, de Haan EH, Kappelle LJ. Cognitive disorders in acute stroke: prevalence and clinical determinants. Cerebrovasc Dis. 2007;23(5-6):408-16. doi: 10.1159/000101464. Epub 2007 Apr 2.

    PubMed 17406110
  • Nys GM, van Zandvoort MJ, de Kort PL, van der Worp HB, Jansen BP, Algra A, de Haan EH, Kappelle LJ. The prognostic value of domain-specific cognitive abilities in acute first-ever stroke. Neurology. 2005 Mar 8;64(5):821-7. doi: 10.1212/01.WNL.0000152984.28420.5A.

    PubMed 15753416
  • Tatemichi TK, Paik M, Bagiella E, Desmond DW, Pirro M, Hanzawa LK. Dementia after stroke is a predictor of long-term survival. Stroke. 1994 Oct;25(10):1915-9. doi: 10.1161/01.str.25.10.1915.

    PubMed 8091433
  • Hobson P, Meara J. Cognitive function and mortality in a community-based elderly cohort of first-ever stroke survivors and control subjects. J Stroke Cerebrovasc Dis. 2010 Sep-Oct;19(5):382-7. doi: 10.1016/j.jstrokecerebrovasdis.2009.07.006. Epub 2010 May 15.

    PubMed 20472471
  • Pasquini M, Leys D, Rousseaux M, Pasquier F, Henon H. Influence of cognitive impairment on the institutionalisation rate 3 years after a stroke. J Neurol Neurosurg Psychiatry. 2007 Jan;78(1):56-9. doi: 10.1136/jnnp.2006.102533. Epub 2006 Sep 4.

    PubMed 16952914
  • Pollock A, St George B, Fenton M, Firkins L. Top ten research priorities relating to life after stroke. Lancet Neurol. 2012 Mar;11(3):209. doi: 10.1016/S1474-4422(12)70029-7. No abstract available.

    PubMed 22341029
  • Rand D, Eng JJ, Liu-Ambrose T, Tawashy AE. Feasibility of a 6-month exercise and recreation program to improve executive functioning and memory in individuals with chronic stroke. Neurorehabil Neural Repair. 2010 Oct;24(8):722-9. doi: 10.1177/1545968310368684. Epub 2010 May 11.

    PubMed 20460494
  • Quaney BM, Boyd LA, McDowd JM, Zahner LH, He J, Mayo MS, Macko RF. Aerobic exercise improves cognition and motor function poststroke. Neurorehabil Neural Repair. 2009 Nov;23(9):879-85. doi: 10.1177/1545968309338193. Epub 2009 Jun 18.

    PubMed 19541916
  • Marzolini S, Oh P, McIlroy W, Brooks D. The effects of an aerobic and resistance exercise training program on cognition following stroke. Neurorehabil Neural Repair. 2013 Jun;27(5):392-402. doi: 10.1177/1545968312465192. Epub 2012 Nov 16.

    PubMed 23161865
  • Feng J, Spence I, Pratt J. Playing an action video game reduces gender differences in spatial cognition. Psychol Sci. 2007 Oct;18(10):850-5. doi: 10.1111/j.1467-9280.2007.01990.x.

    PubMed 17894600
  • Green CS, Bavelier D. Action video game modifies visual selective attention. Nature. 2003 May 29;423(6939):534-7. doi: 10.1038/nature01647.

    PubMed 12774121
  • Franceschini S, Gori S, Ruffino M, Viola S, Molteni M, Facoetti A. Action video games make dyslexic children read better. Curr Biol. 2013 Mar 18;23(6):462-6. doi: 10.1016/j.cub.2013.01.044. Epub 2013 Feb 28.

    PubMed 23453956
  • Lieberman DA. Designing serious games for learning and health in informal and formal settings. In: Ritterfeld U, Cody MJ, Vorderer P, editors. Serious games: mechanisms and effects. New York: Routledge; 2009. p 117-30.

Questions about this trial

What is this clinical trial studying?

A study testing Wii Fit(30 Mins), Tetrax biofeedback(30 Mins) and Conventional weight-shifting(30 Mins) in people with Stroke, run by Chang Gung Memorial Hospital at 1 site in Taiwan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 8 Jan 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from Baseline in Cognitive Abilities Screening Instrument Scale Chinese version (CASI C-2.0) (time frame: Subjects will be assesed at 12 weeks and 24 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02553993, which also lists 37 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Jan 2016.

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