Results Table Video Game Training – upper extremity Last updated: 21-10-2017 Author, Year Outcome and significance: Sample size Intervention PEDro Score, Country (+) significant (-) not significant Chen et al., 2015 28 patients with chronic Nintendo WiiTM upper extremity training (n=9) At 8 weeks (post-treatment): PEDro score: N/A (quasi- stroke vs. (-) Fugl-Meyer Assessment experimental study design) XaviX®Port upper extremity training (n=11) (-) Box and Block Test Country: Taiwan vs. (-) Functional Independence Measure Conventional upper extremity equipment (n=8) (-) Range of motion (UE - proximal, distal) Treatment details: (+) Motivation and enjoyment interviewer- 30-minutes/session, 3 times/week for 8 weeks. administered questionnaire* Nintendo WiiTM: bowling and boxing games. * Enjoyment was significantly greater in the XaviX®Port: bowling and ladder climbing games. Nintendo WiiTM and XaviX®Port groups vs. Conventional upper extremity equipment: Curamotion conventional rehabilitation group. exerciser and climbing board and bar. All groups also received conventional rehabilitation (physical therapy, occupational therapy) for 1 hour/session, 3 times/week for 8 weeks. Choi et al., 2014 20 patients with Nintendo WiiTM upper extremity training (n=10) At 4 weeks (post-treatment): PEDro score: 8 acute/subacute stroke vs. (-) Fugl-Meyer Assessment – Upper extremity Country: Korea Occupational therapy (OT) upper extremity training score (n=10) (-) Manual Function Test Treatment details: (-) Box and Block Test 30 minutes/session, 5 times/week for 4 weeks. (-) Grip strength (dynamometer) Nintendo WiiTM: Wii Sports and Resort programs (-) Korean version of the Mini-Mental State consisting of 12 games such as swordplay, table tennis, Examination and canoe games performed with the affected UE. (-) Visual and Auditory Continuous Performance Occupational therapy: goal-oriented and repetitive Tests training of the upper extremity (e.g. stretching, range of (-) Korean version of the Modified Barthel Index motion, activities of daily living training, fine motor training, sensory motor recovery). Both groups also received conventional rehabilitation (not occupational therapy), intensity not specified. PAGE 1 OF 8 Results Table Video Game Training – upper extremity Last updated: 21-10-2017 Author, Year Outcome and significance: Sample size Intervention PEDro Score, Country (+) significant (-) not significant da Silva Ribeiro et al., 2015 30 patients with chronic Nintendo WiiTM (n=15) At 2 months (post-treatment): PEDro score: 7 stroke vs. (-) Short-Form 36 (SF-36) – Total Country: Brazil Conventional physical therapy (n=15) (-) SF-36 – Physical functioning* Treatment details: (-) SF-36 – Physical aspects 60-minutes/session, 2 times/week for 2 months. (-) SF-36 – Pain Nintendo WiiTM: tennis, hula-hoop, soccer and boxing (-) SF-36 – General health status games were applied with increasing level of difficulty. (-) SF-36 – Vitality Conventional physical therapy: upper and lower limb (-) SF-36 – Social aspects stretching, muscle strengthening exercises, trunk (-) SF-36 – Emotional aspects mobilisation, balance, mobility and transfers training. (-) SF-36 – Mental health (-) Fugl-Meyer Assessment (FMA) – Total (-) FMA – Passive motion and pain (-) FMA – Sensitivity (-) FMA – UE motor function (-) FMA – UE coordination (-) FMA – Lower extremity (LE) motor function (-) FMA – LE coordination (-) FMA – Balance * Results in favor of conventional physical therapy vs. Nintendo WiiTM. Givon et al., 2016 47 patients with chronic Upper extremity video game training (n=23) At 3 months (post-treatment): PEDro score: 7 stroke vs. (-) 10 Meter Walk Test Country: Israel Conventional exercises (n=24) (-) Grip strength (Jamar Dynamometer) Treatment details: affected/unaffected hand 1-hour session, 2 times/week for 3 months. (-) Number of steps walked per day (hip Video game upper extremity training: provided in group of accelerometer, Acticial Minimitter Co.) 6-8 participants; all games were played in pairs while (-) Action Research Arm Test standing; 3/5 of the following video game consoles were At 6 months (follow-up): used alternatively each session: Microsoft Xbox Kinect, (-) 10 Meter Walk Test PAGE 2 OF 8 Results Table Video Game Training – upper extremity Last updated: 21-10-2017 Author, Year Outcome and significance: Sample size Intervention PEDro Score, Country (+) significant (-) not significant Sony PlayStation 2 Eyetoy, Sony PlayStation 3 MOVE, (-) Grip strength (Jamar Dynamometer) Nintendo Wii Fit and SeeMe VR system. affected/unaffected hand Conventional exercises: provided in groups; consisted of (-) Number of steps walked per day (hip exercises and functional activities adopted from the accelerometer, Acticial Minimitter Co.) Fitness and Mobility Exercise Program, the Graded (-) Action Research Arm Test Repetitive Arm Supplementary Program, and task- oriented training for upper and lower extremities. Kong et al., 2016 105 patients with acute Nintendo WiiTM upper extremity training (n=35) At 3 weeks (post-treatment): PEDro score : 5 stroke vs. (-) Fugl-Meyer Assessment (FMA – UE) Country: Singapore Occupational therapy upper extremity training (n= 35) (-) Action Research Arm Test (ARAT) vs. (-) Stroke Impact Scale (SIS – UE) No additional upper extremity training (n=35) (-) Functional Independence Measure (FIM) Treatment details: (-) Upper extremity pain - Visual Analogue Scale 60-minutes/session, 4 times/week for 3 weeks. (VAS) Nintendo WiiTM upper extremity training: Wii Sports and At 1 month (follow-up): Wii Sports Resort software games such as boxing, (-) FMA – UE bowling, tennis, golf, baseball, table tennis, basketball, (-) ARAT cycling, Frisbee disk, sword play and airplane flight control (-) SIS – UE using the affected UE. (-) FIM Occupational therapy upper extremity training: stretching, (-) Upper extremity pain (VAS) strengthening, range of motion, and task-oriented At 3 months (follow-up): therapy. (-) FMA – UE All groups received conventional rehabilitation (physical (-) ARAT and occupational therapy) for 1-hour sessions, 5 (-) SIS – UE times/week for 3 weeks. (-) FIM (-) Upper extremity pain (VAS) PAGE 3 OF 8 Results Table Video Game Training – upper extremity Last updated: 21-10-2017 Author, Year Outcome and significance: Sample size Intervention PEDro Score, Country (+) significant (-) not significant McNulty et al., 2015 41 patients with Nintendo WiiTM upper extremity training (n=21) At 10 days (post-treatment): PEDro score: 8 subacute/chronic stroke vs. (-) Wolf-Motor Function Test (WMFT) – timed Country: Australia Modified-constraint induced movement therapy (mCIMT, tasks n=20) (-) WMFT – maximal strength Treatment details: (-) WMFT – submaximal strength 60 minutes/session over 10 consecutive weekdays. (-) Motor Activity Log - Quality of Movement Nintendo WiiTM upper extremity training: Wii Sports (MAL-QOM) games of golf, boxing, baseball, bowling, and tennis (-) Fugl-Meyer Assessment – Upper Extremity performed with the affected hand. Training sessions were subscore (FMA-UE) augmented by progressively increasing home practice. (-) Box and Block Test (BBT) mCIMT: wearing a mitt on the less-affected hand for up to (-) Grooved Pegboard test 90% of waking hours; shaping training and use of the (-) Range of Motion (ROM) – shoulder affected hand for 15-20 minutes. (flexion/extension/abduction) (-) ROM - elbow (flexion) (-) ROM – wrist (flexion/extension) (-) ROM – digit I and II (flexion) (-) Modified Ashworth Scale (MAS) (-) Self-perceived improvement (standardized questionnaire) (-) Satisfaction (10-point Visual Analogue Scale) At 6 months (follow-up): (-) WMFT – timed tasks (-) WMFT – maximal strength (-) WMFT – submaximal strength (-) MAL-QOM (-) FMA-UE (-) BBT (-) Grooved Pegboard (-) ROM – shoulder (flexion/extension/abduction) PAGE 4 OF 8 Results Table Video Game Training – upper extremity Last updated: 21-10-2017 Author, Year Outcome and significance: Sample size Intervention PEDro Score, Country (+) significant (-) not significant (-) ROM – elbow (flexion) (-) ROM – wrist (flexion/extension) (-) ROM – digit I and II (flexion) (-) MAS (-) Continued therapy activities (n) (+) Increased physical activity (n) (-) Decreased physical activity (n) (-) Falls (n) (-) Decreased medication (n) (+) Cross-over uptake (n)* * In favor of mCIMT vs. Nintendo Wii upper extremity training (where more patients from the mCIMT group accepted a post-trial cross- over to the alternate therapy). Note: n = number of participants. Rand et al., 2014 29 patients with chronic Upper extremity training using video games (n=15) At 3 months (post-treatment): PEDro score: 4 stroke vs. (-) Fugl-Meyer Assessment – Upper Extremity Country: Israel Conventional rehabilitation (n=14) score Treatment details: (-) Non-purposeful movements – active* 1-hour/session, 2 times/week for 3 months. (-) Non-purposeful movements – passive* Upper extremity training using video games: XBOX Kinect, (+) Purposeful movements – active Sony PlayStation 2 EyeToy, Sony PlayStation 3 MOVE, (-) Purposeful movements – passive SeeMe VR system; performed individually and in groups (+) Movement acceleration – affected upper whereby participants switched between partners and extremity (accelerometer) consoles every 25 minutes. (+) Intensity – affected upper extremity Conventional rehabilitation: UE movements, functional (accelerometer) tasks using therapeutic aids, performed in groups and (-) Movement acceleration – unaffected upper supervised by an occupational therapist. extremity (accelerometer)