Game-based hand resistance exercise versus traditional manual hand exercises for improving hand strength, motor function, and compliance in stroke patients: A multi-center randomized controlled study

BACKGROUND: Game-based exercise is effective for improving strength and motor function in stroke patients undergoing rehabilitation, and it creates fun and motivation for exercise. OBJECTIVE: We investigated the effect of game-based exercise on hand strength, motor function, and compliance in stroke patients. METHODS: Fifty stroke patients were randomly divided into experimental and control groups. The experimental group performed a game-based hand resistance exercise. This exercise was divided into isotonic and isometric types and was performed 30 min/day, 5 days/week, for 6 weeks with 70% of the 1-repetition maximum. In contrast, the control group was given a traditional manual exercise by the occupational therapist, and the type of exercise and time involved were the same as those in the experimental group. The primary outcome measure was hand strength test measured using a dynamometer. Secondary outcome measures were manual function tests (MFT) and hand function tests using box and block test (BBT). Subject-based reports of motivation, fun, pain/fatigue evaluated on 0 to 10 numeric rating scales were compared between groups. RESULTS: After training, hand strength, MFT and BBT was improved in the experimental group compared to the control group (P < 0.001, both). Subject-based reports of motivation and fun was significantly greater in the experimental group than the control group (P < 0.001, both), except to pain/fatigue (P = 0.728). CONCLUSIONS: In conclusion, we demonstrated that game-based exercise is more effective than manual exercise in improving muscle strength, motor function, and compliance in stroke patients.