The effect of rehabilitative games with smartpose practice on upper extremity recovery in ischemic stroke patients

Introduction: Post-stroke motor and functional impairments of the upper extremity significantly impact individuals' independence and quality of life. Upper extremity rehabilitation plays a key role in physiotherapy during the post-stroke recovery process. The recovery process is prolonged and critical for stroke survivors. Technological rehabilitation has expanded therapeutic options by promoting program variability and continuity. However, the high cost and complexity of current technological tools may limit their feasibility and accessibility in routine clinical practice. Objective: The objective of this study is to clinically evaluate the efficacy of the SmartPose application, which employs only a computer camera for data acquisition without the need for external devices, on motor and functional recovery of the upper extremity in patients with ischemic stroke. Method: 36 individuals who met the inclusion criteria were included and randomly assigned to either the neuromuscular exercise + SmartPose group or the neuromuscular exercise group. After collecting clinical and demographic data, assessments were performed using the Fugl-Meyer Assessment for Upper Extremity Sensorimotor Recovery and the Frenchay Arm Test for upper extremity function; the Brunnstrom stages for stroke phase; the Modified Ashworth Scale for Biceps Brachii muscle tone; the Box and Block Test for motor skills; the Functional Independence Measure for activities of daily living; and the Stroke-Specific Quality of Life Scale for quality of life. Assessments were repeated at the end of the study. Both groups received structured exercise training three times a week for 8 weeks. The neuromuscular exercise + SmartPose group received 30 minutes of structured neuromuscular exercises and 30 minutes of SmartPose rehabilitative games, while the neuromuscular exercise group engaged in 1 hour of structured neuromuscular exercises. Results: Following the treatment period, all parameters and subparameters improved statistically significantly in both groups (p < 0.05), except for some subgroups of daily living activities and quality of life. In the between-group comparison, the neuromuscular exercise + SmartPose group showed superior improvement in upper extremity function compared to the neuromuscular exercise group (p < 0.05). Conclusion: Analysis of the results indicated that exercise training performed with SmartPose games was as effective as the neuromuscular exercise program in improving motor function, daily living activities, participation and quality of life. Given its potential to enhance patient engagement and promote long-term adherence, the integration of SmartPose rehabilitative games into neuromuscular exercises may serve as an effective and appealing option.