Abstract:

Hemiparesis, commonly resulting from stroke, significantly impacts hand function, strength, and overall quality of life. Traditional rehabilitation often lacks engagement, leading to low adherence and slower recovery. Gamification, which incorporates game elements into therapeutic exercises, has shown promise in enhancing rehabilitation outcomes. This pilot study aimed to explore the effect of gamification on hand grip strength, hand function, and stress reduction among patients with hemiparesis. A total of 10 participants were randomly divided into two groups with blind fold method, labelled as group A and B, each comprising 5 participants. Over a six -week period, Group A underwent gamification as a therapeutic exercise, while Group B underwent conventional therapy. The two groups’ results discovered a statistically significant variance with the “P-value” was <0.001 in hand function (Jebsen taylor hand function test) post-test. The hand grip strength (Dynamometer) the pre and post-test values for group A and B were assessed as same as above, here for between group comparison statistical difference was not significant for the post test (p<0.07), in group A alone post test results showed statistically significant difference, with “P- value” of <0.001. Finally for the stress post values of PSS showed statistically significant difference. This current study showed that gamification was effective in improving the hand function and grip strength of patient with hemiparesis and specifically it helped in the fine dexterity function improvement and also helped in the reduction in stress level.

References:

[1]. Feigin, V. L., Brainin, M., Norrving, B., Martins, S., Sacco, R. L., Hacke, W., Fisher, M., Pandian, J., and Lindsay, P., 2022, World Stroke Organization (WSO): global stroke fact sheet 2022. International Journal of Stroke, 17(1), pp.18-29. doi.org/10.1177/17474930211065917

[2]. Park, J. G., Lee, K. W., Kim, S. B., Lee, J. H., and Kim, Y. H., 2019, Effect of decreased skeletal muscle index and hand grip strength on functional recovery in subacute ambulatory stroke patients. Annals of Rehabilitation Medicine, 43(5), pp.535-543. doi.org/10.5535/arm.2019.43.5.535

[3]. Mitsungnern, T., Inchanta, S., Kongbunkiat, K., Imoun, S., and Kotruchin, P., 2023, The Impact of Gender on Mortality and Symptomatic Intracerebral Hemorrhage in Acute Ischemic Stroke Patients After Intravenous Recombinant Tissue Plasminogen Activator (rt-PA). Journal of Health Science and Medical Research, 41(4), p.2023934.

[4]. Surapaneni, D., 2024. Biomarkers of hemorrhagic transformation of acute ischemic stroke–A cross-sectional study. Romanian Medical Journal, 71(2).

[5]. Liu, G., Xue, Y., Wang, S., Zhang, Y., and Geng, Q., 2021, Association between hand grip strength and stroke in China: a prospective cohort study. Aging (albany NY), 13(6), p.8204. doi: 10.18632/aging.202630

[6]. Vaishya, R., Misra, A., Vaish, A., Ursino, N., and D’Ambrosi, R., 2024, Hand grip strength as a proposed new vital sign of health: a narrative review of evidences. Journal of Health, Population and Nutrition, 43(1), p.7. doi.org/10.1186/s41043-024-00500-y

[7]. Gajardo Sánchez, A. D., Murillo-Zamorano, L. R., López-Sánchez, J., and Bueno-Muñoz, C., 2023, Gamification in health care management: Systematic review of the literature and research agenda. Sage Open, 13(4), p.21582440231218834. 10.1177/21582440231218834

[8]. Patil, S., Licari, F. W., Bhandi, S., Awan, K. H., Di Blasio, M., Isola, G., Cicciù, M. and Minervini, G., 2024. Effect of game-based teaching on the oral health of children: a systematic review of randomised control trials. Journal of Clinical Pediatric Dentistry, 48(4).

[9]. Laffont, I., Froger, J., Jourdan, C., Bakhti, K., van Dokkum, L. E., Gouaich, A., Bonnin, H. Y., Armingaud, P., Jaussent, A., Picot, M., C., and Le Bars, E., 2020, Rehabilitation of the upper arm early after stroke: video games versus conventional rehabilitation. A randomized controlled trial. Annals of physical and rehabilitation medicine, 63(3), pp.173-180. 10.1016/j.rehab.2019.10.009

[10]. Gajjar, N. P., Noronha, T., Anumasa, R., Mariarathinam, P., and Mariappan, A., 2024, Relationship between Hand grip strength and Hand function in patients with Stroke: A Cross-Sectional Study. Clinical Epidemiology and Global Health, 28, p.101657. 10.1016/j.cegh.2024.101657

[11]. Sığırtmaç, İ. C., and Öksüz, Ç., 2021, Investigation of reliability, validity, and cutoff value of the Jebsen-Taylor Hand Function Test. Journal of Hand Therapy, 34(3), pp.396-403. doi.org/10.1016/j.jht.2020.01.004

[12]. Seo, N. Y., Lee, J. H., and Jung, Y. J., 2024, New Possibilities of A Quantitative Assessment Method for the Jebsen-Taylor Hand Function Test: A Preliminary Study. doi.org/10.21203/rs.3.rs-4464229

[13]. Vasava, S., Sorani, D., Rathod, S., and Vasava, S., 2021, Reliability study of manual and digital handheld dynamometers for measuring hand grip strength. J Emerg Technol Innov Res (JETIR), 8, pp.470-5.

[14]. Lee, S. C., Wu, L. C., Chiang, S. L., Lu, L. H., Chen, C. Y., Lin, C. H., Ni, C. H., and Lin, C. H., 2020, Validating the Capability for Measuring Age‐Related Changes in Grip‐Force Strength Using a Digital Hand‐Held Dynamometer in Healthy Young and Elderly Adults. BioMed research international, 2020(1), p.6936879. 10.1155/2020/6936879

[15]. Chan, S. F., and La Greca, A. M., 2020, Perceived stress scale (PSS). In Encyclopedia of behavioral medicine (pp. 1646-1648). Cham: Springer International Publishing. doi.org/10.1007/978-3-030-39903-0_773

[16]. Vanbellingen, T., Filius, S. J., Nyffeler, T., and Van Wegen, E. E., 2017, Usability of videogame-based dexterity training in the early rehabilitation phase of stroke patients: a pilot study. Frontiers in neurology, 8, p.654. doi.org/10.3389/fneur.2017.00654

[17]. Ali, A. S., and Arumugam, A., 2021, Effectiveness of an intensive, functional, gamified Rehabilitation program in improving upper limb motor function in people with stroke: A protocol of the EnteRtain randomized clinical trial. Contemporary Clinical Trials, 105, p.106381. https://doi.org/10.1016/j.cct.2021.106381

[18]. Kottink, A. I., Prange, G. B., Krabben, T., Rietman, J. S., and Buurke, J. H., 2014, Gaming and conventional exercises for improvement of arm function after stroke: a randomized controlled pilot study. GAMES FOR HEALTH: Research, Development, and Clinical Applications, 3(3), pp.184-191. doi.org/10.1089/g4h.2014.0026.

[19]. Almhdawi, K. A., Alazrai, A., Kanaan, S., Shyyab, A. A., Oteir, A. O., Mansour, Z. M., and Jaber, H., 2021, Post-stroke depression, anxiety, and stress symptoms and their associated factors: a cross-sectional study. Neuropsychological Rehabilitation, 31(7), pp.1091-1104. doi.org/10.1080/09602011.2020.1760893

[20]. Ramírez-Moreno, J. M., Vega, P. M., Espada, S., Alberca, S. B., Aguirre, J., and Peral, D., 2020, Association between self-perceived psychological stress and transitory ischaemic attack and minor stroke: A case–control study. Neurología (English Edition), 35(8), pp.556-562. doi.org/10.1016/j.nrleng.2017.09.004

[21]. Tăut, D., Pintea, S., Roovers, J. P. W., Mananas, M. A., and Băban, A., 2017, Play seriously: Effectiveness of serious games and their features in motor rehabilitation. A meta-analysis. NeuroRehabilitation, 41(1), pp.105-118. doi.org/10.3233/NRE-171462

[22]. Zeiler, S. R., and Krakauer, J. W., 2013, The interaction between training and plasticity in the poststroke brain. Current opinion in neurology, 26(6), pp.609-616. DOI: 10.1097/WCO.0000000000000025.

[23]. Bertrand, A. M., Fournier, K., Brasey, M. G. W., Kaiser, M. L., Frischknecht, R., and Diserens, K., 2015, Reliability of maximal grip strength measurements and grip strength recovery following a stroke. Journal of Hand Therapy, 28(4), pp.356-363. doi.org/10.1016/j.jht.2015.04.004

[24]. Shang, X., Meng, X., Xiao, X., Xie, Z., and Yuan, X., 2021, Grip training improves handgrip strength, cognition, and brain white matter in minor acute ischemic stroke patients. Clinical Neurology and Neurosurgery, 209, p.106886. https://doi.org/10.1016/j.clineuro.2021.106886

[25]. Tuah, N. M., Ahmedy, F., Gani, A., and Yong, L. N., 2021, A survey on gamification for health rehabilitation care: Applications, opportunities, and open challenges. Information, 12(2), p.91. doi.org/10.3390/info12020091

[26]. Taekema, D. G., Gussekloo, J., Maier, A. B., Westendorp, R. G., and de Craen, A. J., 2010, Handgrip strength as a predictor of functional, psychological and social health. A prospective population-based study among the oldest old. Age and ageing, 39(3), pp.331-337. doi.org/10.1093/ageing/afq022

[27]. Prather, J. G., and Stanfill, A. G., 2023, An integrative review of the utilization of the perceived stress scale in stroke recovery. Journal of Neuroscience Nursing, 55(2), pp.65-71. 10.1097/JNN.0000000000000695

[28]. Prasomsri, J., Jearudomsup, P., Talang, W. P. N., Madadam, N., Plodauksorn, A., Ratchatapan, K., Sukcharoen, W., Warinkaew, S., Wichitphong, C., and Hama, S., 2024, Effect of Home-Based Task-Based Mirror Therapy on Upper Extremity Function in Stroke Patients: A Four-Week Intervention Study. Journal of Health Science and Medical Research, 42(5), p.20241042.

[29]. Umasankar, Y., Srinivasan, V., Suganthirababu, P., and Murugaiyan, P., 2024, Efficacy of Proprioceptive Neuromuscular Facilitation on Jaw Function in Bruxism Among Post Stroke Survivor: A Case Study. International Journal of Experimental Research and Review, 42. doi.org/10.52756/ijerr.2024.v42.025

[30]. Srinivasan, V., Ruthuvalan, V., Raja, S., Jayaraj, V., Sridhar, S., Kothandaraman, M., Suganthirababu, P., Abathsagayam, K., Vishnuram, S., Alagesan, J., and Vasanthi, R. K., 2024, Efficacy of vagal nerve stimulation on anxiety among elderly retired teachers during the COVID-19 pandemic. Work, 79(2), pp.645-652. doi.org/10.3233/WOR-230356

[31]. Ruthubalan, V., Srinivasan, V., Suganthirababu, P., & Abathsagayam, K., 2025, ‘Technological advancements in the treatment of anxiety and quality of sleep among teaching professionals - A pilot study’, Research Journal of Pharmacy and Technology, 18(1), pp. 333-338. 10.52711/0974-360X.2025.00052.

[32]. Priyadarsini, A., Sangavi, H., Jagadeeswari, J., Cecyli, C. and Dayana, B.A.A., 2024. Impact of Mindfulness through Smartphone Applications on the Anxiety among B. Sc. Nursing Students. Journal of Pharmacy and Bioallied Sciences, 16(Suppl 3), pp.S2904-S2906.