Find resources below on studies which complement or reinforce the efficacy of remote therapy solutions.
Self-managed motor-gaming with behavioral telehealth visits has outcomes similar to in-clinic CI therapy. It addresses most access barriers, requiring just one-fifth as much therapist time that is redirected towards behavioral interventions that enhance the paretic arm’s involvement in daily life.
Gauthier, L.V., et al. “Video game rehabilitation for outpatient stroke (VIGoROUS): A multi-site randomized controlled trial of in-home, self-managed, upper-extremity therapy.” eClinicalMedicine. January 2022.Download Study
Children with Cerebral Palsy increased their exercise by 31 min/day and completed more intense exercise. The increased exercise generalized beyond the game to daily life.
Gaming increases the intensity and amount of patient exercise which enhances recovery and positively impacts daily life.
Sandlund M, Waterworth EL, Häger C. Using motion interactive games to promote physical activity and enhance motor performance in children with cerebral palsy. Dev Neurorehabil. 2011;14(1):15-21. doi: 10.3109/17518423.2010.533329. PMID: 21241174.Link to Study
Heart rate during exercise was greater during gaming than conventional exercise (134 vs 126). Gaming also resulted in small, but probably meaningful, improvements in patient independence/function (Rankin scale).
Gaming promotes more intense cardiovascular exercise, which is associated with a small improvement in overall health/wellness compared to more traditional means of exercise. Exercising with games is more efficient and effective than conventional exercise.
Tollár J, Nagy F, Csutorás B, Prontvai N, Nagy Z, Török K, Blényesi E, Vajda Z, Farkas D, Tóth BE, Repa I, Moizs M, Sipos D, Kedves A, Kovács Á, Hortobágyi T. High Frequency and Intensity Rehabilitation in 641 Subacute Ischemic Stroke Patients. Arch Phys Med Rehabil. 2021 Jan;102(1):9-18. doi: 10.1016/j.apmr.2020.07.012. Epub 2020 Aug 27. PMID: 32861668.Link to Study
Active Video Games enable light (upper body) to moderate (lower body engagement) physical activity.
Gaming is an effective tool for motivating more intense physical activity, which will improve the overall health/wellness of patients.
Biddiss E, Irwin J. Active video games to promote physical activity in children and youth: a systematic review. Arch Pediatr Adolesc Med. 2010 Jul;164(7):664-72. doi: 10.1001/archpediatrics.2010.104. PMID: 20603468.Link to Study
75% of gaming group continued to do balance training at home vs 20% in the conventional group. Falls were reduced by 2/3rds in the gaming group and this group also showed an advantage in dual-task walking.
Patients will continue to do gaming exercise when discharged from rehab at much higher rates than traditional home exercises, which improves clinical outcomes.
Kramer A, Dettmers C, Gruber M. Exergaming with additional postural demands improves balance and gait in patients with multiple sclerosis as much as conventional balance training and leads to high adherence to home-based balance training. Arch Phys Med Rehabil. 2014 Oct;95(10):1803-9. doi: 10.1016/j.apmr.2014.04.020. Epub 2014 May 10. PMID: 24823959.Link to Study
Smart-phone motion capture is generally consistent with lab-based motion capture and sufficient to capture patient improvement. Surveying the main movement direction of the implemented exercises (squats, step-ups, side-steps), differences between 10.13 mm to 24.59 mm were measured.
RxGames utilizes mobile device cameras to accurately capture patient movements and produces comprehensive home exercise session reports to create visibility for therapists.
Guggenberger B, Jocham AJ, Jocham B, Nischelwitzer A, Ritschl H. Instrumental Validity of the Motion Detection Accuracy of a Smartphone-Based Training Game. Int J Environ Res Public Health. 2021 Aug 9;18(16):8410. doi: 10.3390/ijerph18168410. PMID: 34444160; PMCID: PMC8394475.Link to Study
Home exercise instructions provided on electronic devices cost less than paper-based instructions when patients are using their own smart devices. Each initial exercise instruction provided using electronic devices saved 5.5 min (95% CI 0.5 to 10.5) with a cost saving of Australian dollar $4.70 (95% CI -8.89 to -0.52) compared with paper-based instructions.
Using devices that patients already own saves clinicians time in teaching/scheduling home practice programs.
Emmerson KB, Harding KE, Fong C, Taylor NF. A resource analysis of the use of the video function of electronic devices for home exercise instruction in rehabilitation. Disabil Rehabil. 2021 May;43(10):1391-1395. doi: 10.1080/09638288.2019.1663281. Epub 2019 Sep 17. PMID: 31526061.Link to Study
"Exercises learned only from a brochure without being monitored by a physical therapist were done properly by only about half of the patients and appeared to result in fewer improvements in impairments." "There was a strong correlation between the quality of exercise performance and decrease in pain."
RxGames promotes correct exercise performance because only properly executed exercises drive game play. The games also record the quality of patient movements and share the data with therapist providing true ability to monitor patient home exercise programs.
Friedrich M, Cermak T, Maderbacher P. The effect of brochure use versus therapist teaching on patients performing therapeutic exercise and on changes in impairment status. Phys Ther. 1996 Oct;76(10):1082-8. doi: 10.1093/ptj/76.10.1082. PMID: 8863761.Link to Study
Amongst people with rotator cuff issues, home exercise worked as well as supervised exercise at improving Disabilities of the Arm, Shoulder and Hand questionnaire (Quick-DASH) scores. Home exercise was cheaper.
RxGames technology provides therapists with visibility to patient home exercise compliance and quality of movement metrics which are critical for effective remote therapy monitoring.
Christiansen DH, Hjort J. Group-based exercise, individually supervised exercise and home-based exercise have similar clinical effects and cost-effectiveness in people with subacromial pain: a randomised trial. J Physiother. 2021 Apr;67(2):124-131. doi: 10.1016/j.jphys.2021.02.015. Epub 2021 Mar 17. PMID: 33744191.Link to Study
Amongst people post-ankle fracture, the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scores improved more in the home exercise group and home exercise cost on 16% as much as PT-supervised exercise.
In a cost analysis of traditional rehab vs at-home rehab, the patient satisfaction was significantly higher and cost significantly lower in the at-home group. RxGames enables therapists to combine in-clinic rehabilitation with effective home exercise programs.
Büker N, Şavkın R, Ök N. Comparison of Supervised Exercise and Home Exercise After Ankle Fracture. J Foot Ankle Surg. 2019 Sep;58(5):822-827. doi: 10.1053/j.jfas.2018.11.021. PMID: 31474396.Link to Study
Reallocating in-clinic motor training to a game-based home exercise program achieved similar meaningful gains in motor capacity. Therapists were able to focus limited in-session time on best practice behavior change techniques, which improved carry-over of arm function to daily activities. Most patients were able to achieve the guidelines-recommended amount of physical activity through the home exercise program.
Incorporation of a game-based home exercise program improves carry-over of motor gains to daily activities and helps patients achieve recommended amounts of physical activity. Patients achieved successful outcomes with a limited number of physical therapy visits. RxGames technology was used as the basis for this study.
Gauthier LV, Nichols-Larsen DS, Uswatte G, Strahl N, Simeo M, Proffitt R, Kelly K, Crawfis R, Taub E, Morris D, Lowes LP, Mark V, Borstad A. Video game rehabilitation for outpatient stroke (VIGoROUS): A multi-site randomized controlled trial of in-home, self-managed, upper-extremity therapy. EClinicalMedicine. 2021 Dec 17;43:101239. doi: 10.1016/j.eclinm.2021.101239. PMID: 34977516; PMCID: PMC8688168.Link to Study
Amongst people with heart failure, providing a remotely monitored home exercise program involving 3 x 30 minutes/week of moderate cardiovascular intensity decreases readmissions from 14% to 5%. The 30-day readmission rate for patients reduced from 13.6% to 4.1% after home exercise programs, and the 6-month readmissions rate in the intervention group was 4.6%. There was a clinically meaningful improvement in 6-minute walk distance in the home exercise group but not the control group.
RxGames enables home exercise to be effectively monitored remotely. Remotely monitored exercise reduces readmission of heart failure patients and improves their physical capacity.
-Tsai WJ, Wen YK, Cheng YY, Huang JL, Chen YW. Effectiveness of home-based telerehabilitation programs on functional capacity and cardiac function in elderly heart failure patients: A prospective longitudinal study. Medicine (Baltimore). 2022 Jul 15;101(28):e29799. doi: 10.1097/MD.0000000000029799. PMID: 35838996.Link to Study
This model of delivering CI therapy using a custom, avatar-based virtual reality game was well received. Patients expressed a preference for game-based exercise.
This study was conducted using RxGames technology. The games make exercises fun for patients which leads to significantly higher compliance with home exercise programs.
Borstad AL, Crawfis R, Phillips K, Lowes LP, Maung D, McPherson R, Siles A, Worthen-Chaudhari L, Gauthier LV. In-Home Delivery of Constraint-Induced Movement Therapy via Virtual Reality Gaming. J Patient Cent Res Rev. 2018 Jan 30;5(1):6-17. doi: 10.17294/2330-0698.1550. PMID: 31413992; PMCID: PMC6664341.Link to Study
Key findings from this study: 1) treatment compliance: video-games-78%, traditional therapy-66%; 2) patient satisfaction: video-game (93%), traditional therapy (71%)
RxGames provides clinics with the opportunity to prescribe video game based home exercised programs similar to those used in this study that resulted in higher compliance and greater patient satisfaction.
Givon N, Zeilig G, Weingarden H, Rand D. Video-games used in a group setting is feasible and effective to improve indicators of physical activity in individuals with chronic stroke: a randomized controlled trial. Clin Rehabil. 2016 Apr;30(4):383-92. doi: 10.1177/0269215515584382. Epub 2015 May 7. PMID: 25952586.Link to Study