Exercise as it relates to Disease/Computer gaming for stroke rehabilitation

Prevalence
Stroke is Australia’s second biggest killer after coronary heart disease, and a leading cause of disability. In 2012, there were over 420,000 people living with the effects of stroke. Two thirds of these people sustained a disability that impeded their ability to carry out activities of daily living unassisted. By 2032 there will be around 709,000 Australians living with stroke, or 2.4% of the population.

Three Major Types of Stroke
Ischemic stroke - Sudden blockage of arteries supplying the brain Intracerebral haemorrhage - Bleeding from one of the brain’s arteries into the brain tissue.
 * Thrombotic - Clot forms within the artery due to atherosclerosis.
 * Embolic - Clot formed in another part of the circulation, which follows the blood stream until it obstructs arteries in the brain.

Subarachnoid haemorrhage - Arterial bleeding in the space between the two meninges, pia mater and arachnoidea.

Effects of Stroke

 * Development of epilepsy
 * Hemiplegia (Paralysis of one side of the body)
 * Chronic pain
 * Dysphagia (inability or difficulty swallowing)
 * Cognitive deficits including dyspraxia (difficulty with coordination), aphasia (impaired ability to understand or produce speech), memory loss and inability to keep attention
 * Recognition deficits (impairment of the senses)

Barriers to rehabilitation
The effects of a stroke creates many barriers to physical activity for rehabilitation.These factors include:
 * Limb paralysis
 * Impaired movement coordination and balance
 * Motivation/Depression
 * Cardiovascular endurance
 * Time and ability to access facilities for rehabilitation

Computer Games for Rehabilitation
Adherence to rehabilitation is a main issue in stroke rehabilitation with cost, time and access to facilities key problems. Computer games or exergames such as the Nintendo Wii console with Wii Sports game and Wii Fit balance board have become popular tools in stroke rehabilitation as they are low cost and can be used at home. Not only are these computer games an affordable and convenient way of assisting rehabilitation they also have physiological and psychological benefits. These include:
 * Improving balance. and motor function
 * Improving quality of life
 * Improving rehabilitation compliance as it enables the sufferer to take their mind of their disabilities, focus on playing & enjoying the game and have a greater interaction with friends and family
 * Meeting physical activity guideline recommendations.

Recommendations

 * Computer games should be done to compliment traditional rehabilitation programs involving aerobic and resistance training especially in the immediate months following the stroke.
 * Computer gaming session duration should mimic those of traditional rehabilitation sessions going for 20-60mins or mulitple 10min sessions & played with friends or family to increase enjoyment and adherence

Further Information

 * Neurosciene Research Australia Website and Computer games aren't just for kids
 * Stroke Foundation Website Video: Wii-based Movement Therapy for stroke rehabilitation