Dance Therapy for Stroke

Overseen By Tanvi Bhatt, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Illinois at Chicago

Must not be taking: Sedatives, Botox

Disqualifiers: Severe illness, Cardiovascular, Pulmonary, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 20

Duration: 6 weeks

120 Participants Needed

Trial Summary

What is the purpose of this trial?

Neurological impairment is a devastating disease for patients and their families and a leading cause of adult disability. Traditional rehabilitative therapies can help regain motor function and ameliorate disability. However, health care reimbursed rehabilitation is usually provided for up to 6 months post stroke (3 months in form of inpatient therapy and 3 months in outpatient therapy). There are increasing community and other facilities offering rehabilitation in form of conventional, recreational and alternative (Yoga, Tai-chi) therapy. However, implementation of these conventional therapy techniques in individuals with neurological disorder impairments is tedious, resource-intensive, and costly, often requiring transportation of patients to specialized facilities. Based on recent evidence suggesting significant benefits of repetitive, task-orientated training, investigators propose to evaluate the feasibility of an alternative dance and gaming based virtual dance and gaming based therapy to improve overall physical function of community-dwelling individuals with neurological impairments, compared to conventional therapeutic rehabilitation. This pilot study aims to systematically obtain pilot data on compliance and efficacy as well as performing power analysis and sample size calculation for developing it into a randomized controlled trial for extramural funding purposes. The objective of the study is to determine the safety, feasibility, compliance and efficacy of an alternative dance and gaming-based virtual gaming therapy to improve overall physical function of community-dwelling individuals with neurologically impairment and compare it to that of conventional rehabilitation and also to determine the gains in community participation and integration with longer-term compliance to the dance and gaming -based intervention.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, if you have Parkinson's disease, your medication use should be stable.

What data supports the effectiveness of the treatment Virtual-reality based dance training for stroke rehabilitation?

Research shows that virtual reality (VR) and interactive video gaming can help improve motor function and daily activities in stroke patients. Additionally, VR-based physical therapy has been effective in improving balance, gait, and motor function in patients with motor deficits, suggesting potential benefits for stroke rehabilitation. ^{1 2 3 4 5}

Is dance therapy using virtual reality safe for stroke patients?

Virtual reality games, like Wii Sports®, have been used safely as part of stroke rehabilitation, providing motivation and enjoyment during exercise without reported safety concerns. ^{1 2 4 6 7}

How is virtual-reality based dance training different from other stroke treatments?

Virtual-reality based dance training is unique because it uses interactive video gaming to make rehabilitation more engaging and enjoyable, which can improve motivation and compliance compared to traditional therapies. This approach allows patients to practice movements in a simulated environment, potentially enhancing motor and cognitive recovery. ^{2 4 6 7 8}

Research Team

Tanvi Bhatt

Principal Investigator

University of Illinois Chicago

Eligibility Criteria

This trial is for adults aged 18-90 with a history of stroke, Parkinson's disease, or Multiple Sclerosis. They must be able to stand and walk (with aids if necessary), follow instructions in English, and have sufficient cognitive function. Stroke patients need some upper limb function; Parkinson's patients should be on stable medication without severe fluctuations; MS patients can't have severe disability.

Inclusion Criteria

Able to follow instructions provided in English

I can stand and walk on my own or with help like a cane or walker.

I have had a neurological condition like stroke, Parkinson's, or MS for over 6 months.

Exclusion Criteria

Uncontrolled hypertension (systolic blood pressure (SBP) > 165 mmHg and/or diastolic blood pressure (DBP) > 110 mmHg during resting)

I experience shortness of breath.

Participants unavailable for 12 weeks of participation

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive virtual-reality based dance training for 6 weeks using the Kinect dance game

6 weeks

20 sessions (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Long-term compliance monitoring

Participants' compliance and gains in community participation and integration are evaluated

12 weeks

Treatment Details

Interventions

• Virtual-reality based dance training

Trial Overview The study tests virtual-reality based dance training as an alternative therapy to improve physical function in individuals who've had a stroke. It compares the effectiveness of this innovative approach against conventional rehabilitation methods.

Participant Groups

Group I: Virtual-reality based dance group Experimental Treatment 1 Intervention

Virtual-reality based dance training - Participants received Virtual-reality based dance training for 6 weeks using the commercially available Kinect dance game (Microsoft Inc., Redmond, WA, U.S.A.) "Just Dance 3". The six week session consisted of 5 sessions/week, next two weeks of 3 sessions/week and last two weeks of 2 sessions/week, for a total of 20 sessions. Participants played on 10 songs for the first 2 weeks, progressing to 12 songs during the 3nd and 4th weeks with an addition of 2 more songs of their choice during the last two weeks. Participants played on alternating slow- and fast-paced songs (each maximum of 4 minutes in duration) with a five minutes break after a set of one slow and fast song.

Who Is Running the Clinical Trial?

University of Illinois at Chicago

Lead Sponsor

Trials

653

Recruited

1,574,000+

Findings from Research

Using commercial video games like the Nintendo Wii® in virtual reality rehabilitation for stroke patients showed significant improvements in dynamic balance, upper limb motor function, and quality of life, based on an integrative review of 13 studies involving 5-47 participants each.

The virtual reality interventions were found to be more effective than conventional treatments specifically for improving dynamic balance, although some studies did not report changes in static balance or daily living activities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality in the rehabilitation of patients with stroke: an integrative review. Aramaki, AL., Sampaio, RF., Reis, ACS., et al.[2020]

Virtual reality therapy significantly improves upper limb function and activities of daily living in stroke rehabilitation compared to conventional therapy, based on a review of 19 studies with 565 participants.

While virtual reality shows promise, it did not demonstrate significant effects on grip strength or gait speed, indicating that more research is needed to fully understand its benefits in stroke recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cochrane review: virtual reality for stroke rehabilitation. Laver, K., George, S., Thomas, S., et al.[2022]

A review of 121 papers on virtual reality (VR) for post-stroke rehabilitation found that only 64% explicitly defined VR, highlighting a need for consistent terminology in the field.

The study developed a new taxonomy categorizing 16 mixed reality systems based on display type, information mixing, and input devices, which could improve communication and understanding of the efficacy and feasibility of different VR rehabilitation systems.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Use of the Term Virtual Reality in Post-Stroke Rehabilitation: A Scoping Review and Commentary. Huygelier, H., Mattheus, E., Abeele, VV., et al.[2023]

Stroke patients reported positive experiences using Wii Sports® as a supplement to traditional occupational therapy, highlighting its ability to connect them with their past, present, and future activities.

The study, involving nine Danish stroke patients over three weeks, found that Wii Sports® provided variety and engagement in rehabilitation, while also presenting challenges that could motivate patients in their recovery process.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Stroke patients' experiences with Wii Sports® during inpatient rehabilitation. Celinder, D., Peoples, H.[2016]

A 58-year-old man with right hemiplegia showed significant improvements in gait and lower limb motor function after 8 weeks of VR-based physical therapy combined with traditional therapy, indicating the efficacy of this approach.

The use of VR technology provided real-time feedback that enhanced rehabilitation outcomes, as evidenced by increased step length, stride length, and a rise in the Fugl-Meyer assessment score from 18 to 23 points.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improved Balance, Gait, and Lower Limb Motor Function in a 58-Year-Old Man with Right Hemiplegic Traumatic Brain Injury Following Virtual Reality-Based Real-Time Feedback Physical Therapy. Kim, KH., Kim, DH.[2023]

In a study involving 20 participants (10 with chronic stroke and 10 healthy adults), the EyeToy console was found to elicit significantly greater movement intensity compared to the Wii console for both groups, indicating its potential for enhancing rehabilitation exercises.

Both the EyeToy and Wii consoles were rated highly for usability and enjoyment, making them suitable options for stroke rehabilitation, but clinicians may prefer EyeToy for encouraging more intense movements.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sony PlayStation EyeToy elicits higher levels of movement than the Nintendo Wii: implications for stroke rehabilitation. Neil, A., Ens, S., Pelletier, R., et al.[2016]

Wii-based Movement Therapy offers a promising alternative to traditional rehabilitation methods for stroke patients, addressing barriers like access, cost, and patient compliance.

This therapy has shown success in improving patient re-engagement in the community after treatment, indicating its potential effectiveness in post-stroke rehabilitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Games for Rehabilitation: Wii-based Movement Therapy Improves Poststroke Movement Ability. McNulty, PA.[2015]

The pilot study aims to assess the feasibility and tolerability of a therapeutic virtual reality (VR) platform in inpatient stroke rehabilitation, focusing on its potential to enhance upper extremity recovery and pain management for veterans over a 4-6 week period.

Preliminary findings suggest that VR interventions could provide effective adjunct therapy in stroke rehabilitation, with the potential for seamless transition from hospital to home, thereby improving patient engagement in self-management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Immersive Virtual Reality to Improve Outcomes in Veterans With Stroke: Protocol for a Single-Arm Pilot Study. Tran, JE., Fowler, CA., Delikat, J., et al.[2021]

References

1. Germany pubmed.ncbi.nlm.nih.gov

Virtual reality in the rehabilitation of patients with stroke: an integrative review. [2020]

2. Italy pubmed.ncbi.nlm.nih.gov

Cochrane review: virtual reality for stroke rehabilitation. [2022]

3. England pubmed.ncbi.nlm.nih.gov

The Use of the Term Virtual Reality in Post-Stroke Rehabilitation: A Scoping Review and Commentary. [2023]

4. England pubmed.ncbi.nlm.nih.gov

Stroke patients' experiences with Wii Sports® during inpatient rehabilitation. [2016]

5. United States pubmed.ncbi.nlm.nih.gov

Improved Balance, Gait, and Lower Limb Motor Function in a 58-Year-Old Man with Right Hemiplegic Traumatic Brain Injury Following Virtual Reality-Based Real-Time Feedback Physical Therapy. [2023]

6. Italy pubmed.ncbi.nlm.nih.gov

Sony PlayStation EyeToy elicits higher levels of movement than the Nintendo Wii: implications for stroke rehabilitation. [2016]

7. United States pubmed.ncbi.nlm.nih.gov

Games for Rehabilitation: Wii-based Movement Therapy Improves Poststroke Movement Ability. [2015]

8. Canada pubmed.ncbi.nlm.nih.gov

Immersive Virtual Reality to Improve Outcomes in Veterans With Stroke: Protocol for a Single-Arm Pilot Study. [2021]