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StrokeNCT02759328

Xbox Kinect™ Training for Stroke Rehabilitation

A study testing Xbox Kinect™ training and Conventional rehabilitation in people with Stroke, run by Ankara University at 1 site in Turkey (Türkiye).

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

Commercial interactive game consoles including the Nintendo Wii™ and the Sony Playstation Eyetoy™ have been used in stroke rehabilitation with variable success and seemed to be safe, feasible and effective treatment options. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Stroke
What is being tested?
Xbox Kinect™ training and Conventional rehabilitation
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteTurkey (Türkiye)
Study dates
Dec 2012to Mar 2014
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 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • First-time ischemic or hemorrhagic stroke occurring in the last 9 months
  • Between 18 and 80 years of age
  • Brunnstrom motor recovery stage in the affected upper extremity ≥ 3
  • Ability to understand and follow simple explanations and commands
  • Mini-Mental State Examination score of ≥ 24

Who cannot join

  • History of epilepsy or seizure (except childhood febrile seizures)
  • Arthritis or pain restricting the repetitive training of the affected upper extremity
  • Severe aphasia
  • Neglect phenomena
  • Cognitive or psychiatric disorders
  • ≥ Grade 3 spasticity in the affected upper extremity according to Modified Ashworth Scale
  • Medical conditions which may affect physical performance or the physical activity may become unsafe (unstable angina, myocardial infarction within the last 3 months, uncontrolled blood pressure, pulmonary disease, etc.)
  • Participation in another clinical trial

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Ankara University Faculty of Medicine, Cebeci Research and Application Hospital

    Ankara, Ankara, 06620

Other trials in Turkey (Türkiye)

About this study

Official title: Clinical Feasibility of the Xbox Kinect™ Training for Stroke Rehabilitation: a Single Blind Randomized Controlled Pilot Study

Commercial interactive game consoles including the Nintendo Wii™ and the Sony Playstation Eyetoy™ have been used in stroke rehabilitation with variable success and seemed to be safe, feasible and effective treatment options. The more recently released Xbox Kinect™ game console has superiorities to the others such as not requiring any special controller and having a more sensitive sensor which provides more accurate motion-capturing. However, there is limited evidence on clinical utility of the Xbox Kinect™ in stroke rehabilitation. Currently it has been designed for physically and mentally healthy people just like previous consoles. Therefore, the safety and feasibility of the system should be evaluated in first place before using it as an alternative or adjunctive training method in stroke patients. To the best of our knowledge, no studies have evaluated the clinical feasibility of the Xbox Kinect™ in stroke rehabilitation. The aim of this pilot study was to evaluate the feasibility and safety of the Xbox Kinect™ training of upper extremity in subacute stroke rehabilitation. The secondary aim was to evaluate its efficacy on upper extremity motor and functional recovery.

Read the detailed description

This study was planned as a single-blind, randomized controlled, pilot trial. It was approved by the Ankara University Faculty of Medicine Ethics Committee and was conducted in accordance with the Declaration of Helsinki. Stroke patients who were hospitalized for inpatient rehabilitation at the Ankara University Faculty of Medicine, Cebeci Research and Application Hospital, Physical Medicine and Rehabilitation Clinic from December 2012 to March 2014, were assessed to determine their eligibility for the study. All patients were diagnosed with stroke by a neurologist according to World Health Organization stroke definition and confirmed by neuroimaging (computed tomography or magnetic resonance imaging). All patients who fulfilled the inclusion criteria received a detailed explanation of the study and written informed consent was obtained from all participants prior to enrollment. Patient characteristics were collected at baseline including socio-demographic features (age, gender, marital status, educational level, vocation), stroke type, time from stroke onset to enrollment, affected side, handedness, comorbid conditions, spasticity grade (according to Modified Ashworth Scale) and motor recovery stages according to Brunnstrom Motor Assessment Scale (BMAS). Affected upper extremity was examined using the Box and Blocks Test (BBT) and the Wolf Motor Function Test (WMFT). Baseline level of functional independence was assessed using the Functional Independence Measure (FIM). Participants were randomly allocated to two groups; the experimental group and the control group. Both the experimental group and the control group received a conventional rehabilitation program for 4 weeks (60 minutes/day, 5 days/week). The experimental group underwent an additional training with the Xbox Kinect™ for 4 weeks (60 minutes/day, 5 days/week). The primary outcome measures of this pilot study are related to feasibility and safety of the Xbox Kinect™ in subacute stroke rehabilitation. Treatment attendance ratio, which is the proportion of the completed training time to the planned training time, was used as the primary feasibility outcome. The treatment attendance ratios were calculated for three different measurements: total training time, training time per session and the number of sessions. In addition, the result obtained from patient feedback survey was also used as a feasibility outcome. The ratio of patients who had adverse events related to the intervention or any serious adverse event during the study was defined as the primary safety outcome. Rating of perceived exertion measured according to the Borg 10 Point Scale was also used as a safety outcome. To determine the efficacy of the intervention, BBT, WMFT, FIM, BMAS were used as secondary outcome measures. Mean, standard deviation, median, min-max and percentile values were calculated for the socio-demographic and clinical features, primary and secondary outcome measures by descriptive statistics. The Shapiro-Wilk test was used for normality testing. The Wilcoxon signed rank test was used to evaluate differences within groups. The Mann Whitney U test was used to evaluate differences between groups. P value of less than .05 was considered as statistically significant.

Conditions
Stroke
Being tested
Xbox Kinect™ training, Conventional rehabilitation
Keywords
Stroke, Rehabilitation, Serious games, Virtual reality, Xbox Kinect™
Medical subject headings
Stroke

What participants receive

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

  • Xbox Kinect™ trainingBehavioural

    Xbox Kinect™ (Xbox 360, Microsoft, United States) game console which is one of the commercial interactive game consoles was used. It was comprised of 3 components; Kinect™ sensor, Xbox 360™ game console and 42 inch Liquid crystal display (LCD) television.

  • Conventional rehabilitationBehavioural

    The conventional rehabilitation program consisted of passive and active range of motion exercises, therapeutic stretching, muscle strengthening, neurophysiologic exercises, sitting, standing, balance and gait exercises, occupational therapy and activities of daily living training such as eating, grooming, dressing, toileting and transfer.

Study groups in NCT02759328
Study groupRoleWhat they receive
Xbox Kinect™ training groupExperimental60 minutes/day, 5 days/week, 4 weeks (20 sessions) conventional rehabilitation program plus 60 minutes/day, 5 days/week, 4 weeks (20 sessions) Xbox Kinect™ upper extremity training. Two games both of which require using upper extremities, were chosen and each game was played for 30 minutes per session.
Receives: Behavioral: Xbox Kinect™ training
Conventional rehabilitation groupActive comparator60 minutes/day, 5 days/week, 4 weeks (20 sessions) conventional rehabilitation program only. The treatment protocol was individualized according to the goals which were determined depending on each patient's needs and functional level.
Receives: Behavioral: Conventional rehabilitation

What is being measured

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

  1. Treatment attendance ratios

    A feasibility outcome. The proportion of the completed training time to the planned training time.

    Measured: Every training session during 4 weeks (total 20 sessions)

  2. Number of patients with adverse events

    A safety outcome.

    Measured: Every training session during 4 weeks (total 20 sessions)

Secondary outcomes (6)
  1. Box and Blocks Test

    Gross manual dexterity

    Measured: Change from baseline at 4 weeks

  2. Wolf Motor Function Test

    Motor function of the upper extremity

    Measured: Change from baseline at 4 weeks

  3. Functional Independence Measure

    Self-care subscale of FIM will be used to evaluate the upper extremity related functional independence level

    Measured: Change from baseline at 4 weeks

  4. Brunnstrom Motor Assessment Scale

    Motor recovery of the upper extremity

    Measured: Change from baseline at 4 weeks

  5. Patient feedback survey

    Participant's opinions related to ease-of-use and enjoyment of the game system, pain or fatigue during or after the training, duration of sessions, contribution to recovery, using as a treatment approach and suggestion to the other patients.

    Measured: At 4 weeks (after completion of all treatment sessions (total 20 sessions))

  6. Borg 10 Point Scale

    A safety outcome. Rating of perceived exertion and fatigue.

    Measured: Every training session during 4 weeks (total 20 sessions)

Timeline

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

  1. First posted3 May 2016 (estimated)
  2. Study startDec 2012
  3. Primary completionMar 2014
  4. Study completionMar 2014

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
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02759328
Sponsor's protocol ID
20-645-12
Status last verified
Apr 2016
First submitted
28 Apr 2016
Last updated
3 May 2016
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Publications

  • Edmans J, Gladman J, Hilton D, Walker M, Sunderland A, Cobb S, Pridmore T, Thomas S. Clinical evaluation of a non-immersive virtual environment in stroke rehabilitation. Clin Rehabil. 2009 Feb;23(2):106-16. doi: 10.1177/0269215508095875.

    PubMed 19164398
  • Crosbie JH, Lennon S, Basford JR, McDonough SM. Virtual reality in stroke rehabilitation: still more virtual than real. Disabil Rehabil. 2007 Jul 30;29(14):1139-46; discussion 1147-52. doi: 10.1080/09638280600960909.

    PubMed 17613000
  • Laver KE, George S, Thomas S, Deutsch JE, Crotty M. Virtual reality for stroke rehabilitation. Cochrane Database Syst Rev. 2015 Feb 12;2015(2):CD008349. doi: 10.1002/14651858.CD008349.pub3.

    PubMed 25927099
  • Paquin K, Ali S, Carr K, Crawley J, McGowan C, Horton S. Effectiveness of commercial video gaming on fine motor control in chronic stroke within community-level rehabilitation. Disabil Rehabil. 2015;37(23):2184-91. doi: 10.3109/09638288.2014.1002574. Epub 2015 Jan 14.

    PubMed 25586794
  • Sveistrup H. Motor rehabilitation using virtual reality. J Neuroeng Rehabil. 2004 Dec 10;1(1):10. doi: 10.1186/1743-0003-1-10.

    PubMed 15679945
  • Pietrzak E, Cotea C, Pullman S. Using commercial video games for upper limb stroke rehabilitation: is this the way of the future? Top Stroke Rehabil. 2014 Mar-Apr;21(2):152-62. doi: 10.1310/tsr2102-152.

    PubMed 24710975
  • Thomson K, Pollock A, Bugge C, Brady M. Commercial gaming devices for stroke upper limb rehabilitation: a systematic review. Int J Stroke. 2014 Jun;9(4):479-88. doi: 10.1111/ijs.12263. Epub 2014 Mar 24.

    PubMed 24661797
  • Bower KJ, Clark RA, McGinley JL, Martin CL, Miller KJ. Clinical feasibility of the Nintendo Wii for balance training post-stroke: a phase II randomized controlled trial in an inpatient setting. Clin Rehabil. 2014 Sep;28(9):912-23. doi: 10.1177/0269215514527597. Epub 2014 Mar 25.

    PubMed 24668359
  • Pastor I, Hayes HA, Bamberg SJ. A feasibility study of an upper limb rehabilitation system using Kinect and computer games. Annu Int Conf IEEE Eng Med Biol Soc. 2012;2012:1286-9. doi: 10.1109/EMBC.2012.6346173.

    PubMed 23366134
  • Hors-Fraile S, Browne J, Brox E, Evertsen G. Evaluation of sensors for inputting data in exergames for the elderly. Stud Health Technol Inform. 2013;192:935.

    PubMed 23920709
  • Sin H, Lee G. Additional virtual reality training using Xbox Kinect in stroke survivors with hemiplegia. Am J Phys Med Rehabil. 2013 Oct;92(10):871-80. doi: 10.1097/PHM.0b013e3182a38e40.

    PubMed 24051993
  • Lee G. Effects of training using video games on the muscle strength, muscle tone, and activities of daily living of chronic stroke patients. J Phys Ther Sci. 2013 May;25(5):595-7. doi: 10.1589/jpts.25.595. Epub 2013 Jun 29.

    PubMed 24259810
  • Fernandes AB, Passos JO, Brito DP, Campos TF. Comparison of the immediate effect of the training with a virtual reality game in stroke patients according side brain injury. NeuroRehabilitation. 2014;35(1):39-45. doi: 10.3233/NRE-141105.

    PubMed 24990008
  • Bao X, Mao Y, Lin Q, Qiu Y, Chen S, Li L, Cates RS, Zhou S, Huang D. Mechanism of Kinect-based virtual reality training for motor functional recovery of upper limbs after subacute stroke. Neural Regen Res. 2013 Nov 5;8(31):2904-13. doi: 10.3969/j.issn.1673-5374.2013.31.003.

    PubMed 25206611
  • Song GB, Park EC. Effect of virtual reality games on stroke patients' balance, gait, depression, and interpersonal relationships. J Phys Ther Sci. 2015 Jul;27(7):2057-60. doi: 10.1589/jpts.27.2057. Epub 2015 Jul 22.

    PubMed 26311925

Questions about this trial

What is this clinical trial studying?

A study testing Xbox Kinect™ training and Conventional rehabilitation in people with Stroke, run by Ankara University at 1 site in Turkey (Türkiye).

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 5 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 3 May 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 Turkey (Türkiye). 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. 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?

Treatment attendance ratios (time frame: Every training session during 4 weeks (total 20 sessions)). The study lists 2 primary outcomes in all. 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 NCT02759328, which also lists 28 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 3 May 2016.

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Xbox Kinect™ Training for Stroke Rehabilitation | AzTrials