Exergame for post-stroke rehabilitation among elderly patients: A systematic review and meta-analysis
Bibliographic record
Abstract
Advancement in gaming technology, including exergame, is thought to offer a promising innovation in rehabilitative treatment owing to its interactive and joyful natures. Elderly, in addition to being prevalent in stroke, they have different perspectives and adaptability toward the utilization of exergame in post-stroke rehabilitation. The aim of this study was to evaluate the effectiveness of exergame-based rehabilitation in ameliorating stroke-associated cognitive impairment among elderly patients. This systematic review followed the Preferred Reporting Item for Systematic Review and Meta-Analysis (PRISMA) guideline. The literatures were retrieved from the searches on PubMed, Scopus, and Embase databases using a combination of ‘exergame’, ‘stroke’, and ‘elderly’ along with their respective synonyms. Included studies were controlled observational studies and randomized clinical trials with subjects’ mean age >60 years old, measuring global cognitive and/or five cognitive domains (attention, language, executive function, memory, and visuospatial ability). Quality appraisals were performed based on the Cochrane ‘risk-of-bias tool’ and Physiotherapy Evidence Database Scale. Studies with high and good qualities were included in the meta-analyses. Six randomized controlled trials involving 179 patients were included in meta-analysis. Studies had variations in terms of type (combination of exergame-based and conventional rehabilitation or exergame-based only) and duration of interventions (30–110 min), length of observation (2–6 weeks), and tools used to examine cognitive outcomes. As compared with conventional rehabilitation, exergame-based rehabilitation was significantly more effective to improve global cognitive based on Montreal Cognitive Assessment Score in acute stroke patients (n=4; mean difference (MD) 3.66; 95% confidence interval (95%CI): 2.08, 5.24; p<0.00001), but significantly less effective in chronic stroke patients (n=2; MD -1.54; 95%CI: -2.28, -0.81; p<0.0001). In conclusion, global cognitive of elderly patients with acute strokes could be improved through exergame-based rehabilitation which is more effective as compared with conventional therapy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.022 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.038 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".