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September 2006 Issue

Kari Dunning, PhD, (left) and Heather Bernard test one of the computer-assisted video games.
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Rehab Researcher 'Playing Games' With Stroke Victims

Published September 2006

Kari Dunning, PhD, was skeptical at the thought of her stroke patients playing video games as part of their rehabilitation.

“I just couldn’t picture them—especially the older ones—finding this type of therapy beneficial or fun,” says Dunning.

Boy, was she wrong.

Dunning, an assistant professor in the rehabilitation sciences department of the College of Allied Health Sciences, says patients find this new form of rehabilitation, in this case for leg muscles, not only challenging but also lots of fun.

A member of the Neuromotor Recovery and Rehabilitation Laboratory at UC and the Drake Center, Dunning is determining whether a computer-assisted video game can improve balance and walking in patients who are more than one year post stroke.
Her work is supported by a four-year, $259,000 grant from the American Heart Association.
And so far, she says, patients in her lab who have had a chance to try this new equipment really seem to like it.

Biofeedback equipment built into the video game allows patients to watch their progress as they relearn to use muscles whose function has been limited by stroke.

A pilot study in Minnesota, led by the physical therapist/engineer inventor of this unique rehab tool, showed promising results.

“From what we saw in the pilot study,” Dunning says, “this equipment has great potential to improve both walking speed and coordination.”

To “play the game,” the patient sits in a chair with the affected leg on a block or foot stool. Electrodes attached to the calf send feedback into the computer. T
he therapist conducts an initial threshold test to verify the patient’s range of ankle motion, which sets the game at an individualized “level.” On the computer screen are a series of video games that patients then work through at their own pace. Rather than using a joystick, however, they play the game by flexing and extending their foot.

In one game, for instance, the user must paint lines between various sized circles, making sure to lower the ankle to make the line stop in the center of the circle, and raise the toes to then move the line in the opposite direction.

“This movement sounds simple to someone who’s not suffered a stroke, but it’s often very difficult for my patients,” says Dunning.

It’s lack of ankle control that causes walking difficulty among many stroke patients, Dunning says. And this can be a major problem, because the foot may then drag or drop during walking, which can lead to falls.

”Improving walking coordination is so important for these patients,” adds Dunning. “Just being able to cross the street before the light changes definitely improves someone’s quality of life.”


Dunning will study 30 patients over four years—half using the machine coupled with physical therapy, half receiving physical therapy alone. Study participants will go through gait testing at the onset and conclusion of the study. They will also complete a stroke impact scale survey—a widely used tool to gather information about quality of life.

To learn more about rehabilitation research at the University of Cincinnati, visit

Story Sidebar:

For the past 16 years, Drake Center patients have benefited from the work of the Friends of Drake Foundation and countless volunteers.

An annual golf outing, started nine years ago by Steve Bernard after his first wife suffered a crippling stroke, raises money for the foundation and has supported the purchase of many pieces of rehabilitation equipment at the Drake Center.

In fact, proceeds from the 2005 outing were used to buy the computer-based biofeedback equipment for Dunning’s study.

Now remarried, Bernard and his wife, Heather, continue to plan the golf outing each year and recently made a visit to Drake to test-run all the valuable equipment theyve been able to provide. 

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