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Article type: Research Article
Authors: Kannan, Lakshmia | Vora, Jinala | Bhatt, Tanvia; * | Hughes, Susan L.b
Affiliations: [a] Department of Physical Therapy, Cognitive-Motor Behavior and Balance Rehabilitation Laboratory, University of Illinois at Chicago, Chicago, IL, USA | [b] Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
Correspondence: [*] Address for correspondence: Tanvi Bhatt, Department of Physical Therapy, 729, College of Applied Health Sciences, 1919 W. Taylor St., Chicago, IL 60612, USA. Tel.: +1 312 355 4443; E-mail: tbhatt6@uic.edu.
Abstract: BACKGROUND:Dual-task (simultaneous motor and cognitive task) (DT) training via virtual-reality exergaming is known to benefit balance control post-stroke. However, the efficacy of such training on DT balance control (volitional and reactive) and cognitive (executive function and attention) domains associated with fall risk remains unclear. OBJECTIVE:We evaluated the efficacy of cognitive-motor exergame training (CMT) (Wii-fit games in conjunction with cognitive tasks) for improving balance control (volitional and reactive) and cognition (executive function and attention) among people with chronic stroke (PwCS). METHODS:Hemiparetic, ambulatory PwCS were randomly assigned to either CMT (n = 12) or conventional training (CT) (n = 12) and underwent six weeks of high-intensity, tapered balance training. The CMT group performed Wii-fit games in conjunction with cognitive tasks, while CT group underwent customized, progressive balance training. Performance under DT conditions on Limits of Stability (volitional) and Slip-Perturbation (reactive) tests, and letter-number sequencing (cognition) determined the efficacy of CMT. RESULTS:Post-intervention, under DT reactive conditions, CMT group improved both motor and cognition, while the CT group improved motor alone. Under DT volitional conditions, motor performance improved only in CMT group. CONCLUSION:Cognitive-motor exergaming appears to be effective for improving balance control and cognition and could be implemented in clinical stroke rehabilitation settings.
Keywords: Dual-task training, cognitive-motor exergaming, Wii-fit Nintendo, chronic stroke rehabilitation
DOI: 10.3233/NRE-182683
Journal: NeuroRehabilitation, vol. 44, no. 4, pp. 493-510, 2019
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