Circuit exercise therapy is being frequently used as a therapy option for stroke patients undergoing rehabilitation. However, the effectiveness of this therapy in improving post-stroke functionality remains limited. There is also a need to improvise the content of the existing circuit exercise therapy to further enhance the process of neuroplasticity towards the attainment of greater recovery. One strategy for this is to integrate the element of games into the exercise therapy to create a more enriched training environment during the exercise session. This study aimed to determine the feasibility and effectiveness of a game-based circuit exercise therapy among stroke survivors. This was a pilot experimental study involving 30 stroke patients at post-acute phase post-onset (mean age and standard deviation = 58.9 ± 6.6 years; mean Montreal Cognitive Assessment score = 23.4 ± 7.1) and conducted in a district of Kelantan, Malaysia. Simple random sampling method was used in recruiting the study participants. All participants undergone game-based circuit exercise therapy using a game board named “Checkercise” for 45 minutes, twice per week for 8 weeks. The feasibility of the therapy was measured in term of attrition rate, occurrence of adverse effects and feedbacks from the participants. While its effectiveness on post-stroke physical function were assessed with regards to improvement in functional stability and cardiovascular endurance, using Dynamic Gait Index (DGI) and 6-minute Walk Test, respectively. All data were analyzed using the paired samples t test, with the level of significance, p set at < 0.05. Study results shown low attrition rate, no apparent adverse effect, and positive feedbacks from the participants. Improvement in the participants’ mean score for DGI and 6-minute walk test by 7% and 23% respectively (p < 0.05), and medium effect size (Cohen’s d= 0.5 - 0.6) was obtained post-therapy. In conclusion, game-based circuit exercise therapy is feasible and beneficial for stroke survivors. The therapy can potentially be used as a therapy option for this population. A larger study is needed to confirm this study finding.
Despite being becoming popular and heavily used in rehabilitation, the evidence on the effectiveness of Virtual reality-based therapy (VRBT) among persons with knee osteoarthritis (OA) remains limited. The aim of this study was to determine the effects of VRBT on walking endurance and quality of life of older persons with knee OA in comparison to conventional exercise therapy. This was a randomised controlled trial involving 44 participants (mean age and standard deviation = 66.32 ± 5.73 years) who received either a VRBT (experimental group, n = 22) or a conventional exercise therapy (control group, n = 22) for 45 minutes, twice per week for 12 weeks. The outcome of both therapies on walking endurance was measured using Six-Minute Walk Test (6 MWT), while quality of life was assessed using the Malay-version of Short Form-36 (SF-36). Analysis was done by ‘intention-to-treat’ approach, using Mixed Model ANOVA. A significant time-effect (p < 0.05), with large effect size between 0.43 and 0.54 were found for all outcomes following the therapies. An increase of 17% and 19% of 6 MWT scores were obtained in experimental and control group, respectively. Meanwhile, the scores for the physical and mental components of the SF-36 increased by 37.8% and 19.4% in the experimental group, and 45.7% and 20.6% in the control group. However, no significant group and interaction effects were found for all outcomes (p > 0.05). In conclusion, VRBT is comparable with conventional exercise therapy in improving walking endurance and quality of life of persons with knee OA, and can be used as a therapy option for this population.