Intergame analysis of upper limb biomechanics of stroke patients in real and virtual environment

Abstract

The aim of this study was to realize an intergame analysis of upper limb biomechanics of stroke patients in real and virtual environment. Methods: The sample consisted of 11 hemiparetic patients, mean age of 51 ± 7 years. Participants made 15 attempts in two dart games (real and virtual). Elbow kinematics was video recorded during the dart throwing phase. Analysis was conducted using Kinovea software, paired Student’s t-test and Classification Regression Trees. Results: Patients exhibited a higher elbow extension angle (p = 0.008) and greater velocity in the real game (p = 0.005). In the virtual game patients had longer throwing time (p = 0.021) and better performance (fewer absolute errors) (p < 0.0001). The decision tree showed that there was a balance between the frequency of patients who played the virtual and real game and displayed elbow extension angles above 157°. Similar frequencies between velocity = 29 cm/s and >87 cm/s for the virtual and real games were found. In regard to dart throwing time, there was greater frequency of patients with time =1.37 s for the real game and >1.37 s for the virtual game. Conclusion: The patients can evolve satisfactorily in terms of angulation, velocity and time during virtual game training. Thus, we propose that the virtual dart game may be a useful tool in the neurorehabilitation of patients with chronic stroke, in line with therapeutic objectives and the patient’s clinical condition.