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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003EIncreased intensity of rehabilitation is associated with better motor recovery in stroke patients [Kwakkel G et al. \u003Cem\u003EStroke\u003C\/em\u003E 1997]. However, the effectiveness of interactive virtual reality gaming (such as that found with the Nintendo Wii system) for stroke rehabilitation remains unclear. This article presents results from the randomized, single-blinded, Effectiveness of Virtual Reality Exercises in Stroke Rehabilitation [EVREST; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00692523\u0026amp;atom=%2Fspmdc%2F10%2F1%2F22.atom\u0022\u003ENCT00692523\u003C\/a\u003E] study, which investigated this issue.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Ecerebrovascular disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Enursing\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eneurology clinical trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003EIncreased intensity of rehabilitation is associated with better motor recovery in stroke patients [Kwakkel G et al. \u003Cem\u003EStroke\u003C\/em\u003E 1997]. However, the effectiveness of interactive virtual reality gaming (such as that found with the Nintendo Wii system) for stroke rehabilitation remains unclear. Gustavo Saposnik, MD, St. Michael\u0027s Hospital, Toronto, Ontario, Canada, presented results from the randomized, single-blinded, Effectiveness of Virtual Reality Exercises in Stroke Rehabilitation (EVREST; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00692523\u0026amp;atom=%2Fspmdc%2F10%2F1%2F22.atom\u0022\u003ENCT00692523\u003C\/a\u003E) study, which investigated this issue.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003ETwenty-two patients (mean age=61 years) who received standard rehabilitation within 2 months after a mild to moderate stroke (defined as arm deficit of \u22654 on the Chedocke-McMaster scale) were randomized to receive either virtual reality therapy using the Wii system (VRWii; n=11) or recreational therapy (RT; n=11), such as playing cards or Jenga, for eight 60-minute sessions over a 2-week period. Comorbidities included hypertension, dyslipidemia, diabetes mellitus, and atrial fibrillation. Functional status at the time of randomization for the VRWii group included a mean Canadian Neurological Scale of 8.5 (vs 9.7 in the RT group), median Chedocke-McMaster score of 4.0 (vs 4.5 for RT), and a median Barthel Index of 65 (for both groups). A modified Rankin Scale (mRS) of 3 to 4 was noted in 81% of VRWii patients and 63% of RT patients at baseline. The mean time from stroke onset to randomization was 24 days, and baseline characteristics were similar in both groups. Patients in both groups were instructed to use their affected arm predominantly. The primary outcomes were the total time receiving the intervention (assessing feasibility) and the proportion of patients who were experiencing intervention-related adverse events during the study period (assessing safety). The secondary outcome was efficacy, as determined by Wolf Motor Function Test (WMFT), Box and Block Test (BBT), and the Stroke Impact Scale (SIS), performed at a follow-up visit 4 weeks postintervention.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003ENo serious adverse events were observed. Dizziness\/ nausea was noted in one patient in the RT group but none in the VRWii group. Fatigue, determined as Borg scale \u0026gt;13, was observed in 3 patients in the VRWii group versus 2 for RT. Four patients in the RT group reported any symptom during any session versus 6 in the VRWii group.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EEighty percent of patients in the RT group completed all 8 sessions versus 90% of patients in the VRWii group. The mean total session time was 364 minutes and 388 minutes for VRWii and RT, respectively. The mean individual session time was 46.5 minutes and 56.2 minutes for VRWii and RT, respectively. Patients in the VRWii group did significantly better on the WMFT postintervention after adjustment for age, baseline functional status, and stroke severity compared with the RT group. The VRWii group also demonstrated improvement in grip strength, BBT, and SIS at 4 weeks (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/1\/22\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Unadjusted Secondary Outcomes (Efficacy).\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1148056588\u0022 data-figure-caption=\u0022Unadjusted Secondary Outcomes (Efficacy).\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/1\/22\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/1\/22\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/1\/22\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11228\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003EUnadjusted Secondary Outcomes (Efficacy).\u003C\/p\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EReproduced with permission from G. Saposnik, MD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-7\u0022\u003EVRWii may be a useful strategy for home rehabilitation that is focused on promoting motor function after stroke. This innovative interactive approach appears to be safe, feasible, and potentially effective in enhancing motor function after an acute stroke, concluded Dr. Saposnik.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2010 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/10\/1\/22.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzmude\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmude\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}