BALANCE PERFORMANCE OF POST-STROKE PATIENTS ON A “GAME BALANCE” GAME PLATFORM AND ITS CORRELATION WITH FUNCTIONAL TESTS: A CROSS-SECTIONAL STUDY
Stroke. Game Platform. Balance. Neurological Rehabilitation.
Introduction: Commercial platforms are widely used in research to assess and treat balance deficits in post-stroke patients. However, they lack the necessary specificity for the limitations and/or compensations that these patients may present. It is also challenging to extract the captured data, and the accuracy of this capture is questioned. Objective: To develop a low-cost gaming platform called "Game Balance" for analysis and balance training in post-stroke patients. Materials and Methods: This was a quantitative cross-sectional study. For the pilot project, four healthy individuals of both genders were recruited to guide the adjustments and improvements of the developed platform. They provided feedback on the difficulties and ease of use using the System Usability Scale (SUS). For the definitive research, eight post-stroke patients, also of both genders, were recruited from the Physiotherapy Clinic of FACISA (Santa Cruz/RN). This sample was evaluated using clinical scales: Mini-Mental State Examination (MMSE), Functional Ambulation Categories (FAC), The modified Clinical Test of Sensory Interaction and Balance (mCTSIB), National Institute of Health Stroke Scale (NIHSS), Modified Rankin Scale (mRS), and Fugl-Meyer Assessment Scale. The participants also played four rounds of "Game Balance," including one familiarization round and three evaluation rounds, from which an average performance was calculated. After the gaming experience, they were questioned about their experience using the Intrinsic Motivation Task Evaluation Questionnaire. At the end of the assessment, participants received a simple language report on their performance in each test and in "Game Balance." The statistical analysis involved calculating means or medians, standard deviations or quartiles, followed by correlation analysis using Pearson's coefficient based on the identification of normality or non-normality of the data, using Statistical Package for the Social Sciences (SPSS) version 20.0, with a significance level of 5%. Results: For the pilot project, we had n = 4, and by observing their performances and SUS responses, it is evident that game performance directly influenced their feedback on platform usability. Regarding the definitive research, we had n = 8, with a male majority (62.5%), a mean age of 60.88 ± 11.67 years, a majority with ischemic stroke (62.5%), and left hemiparesis (75%), occurring 6.75 ± 4.33 years ago. Significant correlations were found between age and points in "Game Balance" (Pearson's ρ = -0.743; p-value = 0.035), as well as between points and activity time on the platform (Pearson's ρ = -0.738; p-value = 0.037), and between limb balance on the platform and the Rankin scale (Pearson's ρ = -0.745; p-value = 0.034). Conclusions: The platform achieved the proposed objective, with some relationships between the device variables and the physical conditions of the selected population.