Web-Based Game-Focused Exercise in the Home Setting as an Alternative to Hospital-Based Exercise for Stroke Survivors: A Case Study

Abstract

Stroke survivors require continuous exercise therapy to minimize post stroke weakness and functional decline that eventually affect their motivation level and quality of life. However, frequent hospital-based therapy has become less feasible during COVID-19 pandemic due to fear of infection and other restrictions. Therefore, an alternative exercise
method is needed in a home setting. One approach, namely game-focused exercise, has received much attention in recent research, and good evidence has been documented. However, the delivery of game-focused exercises in a home setting with a remote supervision from therapists has not been well researched. This case study dicusses the effects of
a web-based, game-focused exercise conducted in the survivor’s home setting on the motivation level and quality of life. The case was a 58-year-old post-stroke patient, with good cognitive status (Montreal Cognitive Assessment score = 28) who was recruited to undergo the intervention from February to March 2021. The subject performed a game-focused
exercise program using a web-based Checkercise® board for 40 minutes per session, twice a week for eight weeks. The intended outcome of the intervention was measured using the Intrinsic Motivation Inventory (IMI) and Short Form-36 (SF-36) questionnaire. The study results have shown that web-based Checkercise® is doable in the home setting and yielded satisfactory outcomes, with improvement in overall motivation level by 30%, mainly in the subscales of interest/enjoyment, perceived competence, and perceived choice. Further, the subject demonstrated a better health state, illustrated by the lower score in the pressure/tension subscale (22% reduction) of the IMI and increased physical and mental health components score of the SF-36, by 29% and 60%. In conclusion, web-based,
game-focused exercise using the Checkercise® board is beneficial in enhancing post-stroke motivation level and quality of life, and may be considered as a therapy option for this population during COVID-19 pandemic time.