Friday, 4 January 2013

Sony PlayStation EyeToy elicits higher levels of movement than the Nintendo Wii: implications for stroke rehabilitation.

Neil A, Ens S, Pelletier R, Jarus T, Rand D.
Source: Abilities Neurological Rehabilitation, Vancouver, Canada
European Journal of Physical Rehabilitation Medicine. 2012 Nov 21.

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BACKGROUND: Virtual reality (VR) is an emerging trend in stroke rehabilitation. VR gaming consoles in stroke intervention have been shown to increase motivation and enjoyment during exercise. The amount and intensity of movements elicited using these consoles are unknown.

AIM: The aims of this study were: 1) to quantify the amount and intensity of movement elicited from both hands of two groups of individuals ([chronic stroke and without a disability [healthy]); 2) to determine the effect of console (Wii/EyeToy) and group (stroke/healthy) on the amount and intensity of upper extremity movement; 3) to determine the effect of console (Wii/EyeToy) and group (stroke/healthy) on the usability and VR experience.

DESIGN: A cross-sectional design was taken.

SETTING: Outpatient rehabilitation setting and healthy participant’s homes.

POPULATION: Participants included ten adults with stroke and ten adults without a disability. Methods. Participants experienced two games from each console. Amount and intensity of movement was measured using accelerometers on both wrists, while the virtual experience and usability was determined with questionnaires.

RESULTS: No significant differences were found between the consoles usability and experience. EyeToy elicited significantly greater activity count than Wii among the healthy participants (P=0.028) and significantly greater movement intensity in both the stroke (P=0.005) and healthy (P=0.005) groups.

CONCLUSION: Both consoles rated high for usability, enjoyment and satisfaction highlighting their suitability for a range of individuals in stroke rehabilitation. EyeToy provides increased movement and movement intensity.

CLINICAL REHABILITATION IMPACT: Both consoles are suitable for use in stroke rehabilitation however this information can be helpful to clinicians while selecting a gaming console according to the type and intensity of movements that he/she aims to encourage during therapy.

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Thursday, 3 January 2013

Can balance in children with cerebral palsy improve through use of an activity promoting computer game?

Technology and Health Care

Volume 20, Number 6 / 2012; Pages -501-510

Authors: Nerrolyn Ramstrand, Frida Lygnegård

Department of Rehabilitation, School of Health Sciences, Jönköping University, Jönköping, Sweden

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Introduction: This study aimed to evaluate if use of an activity promoting computer game, used in the home (Nintendo Wii Fit; Nintendo Co Ltd, Japan), could influence balance related outcome measures in children with cerebral palsy.

Method: Eighteen children with hemiplegic or diplegic cerebral palsy were recruited for the study. A randomised cross-over design was used with children tested at baseline, after five weeks of playing Wii Fit games and after five weeks without any intervention. Outcome measures of interest included: performance on the modified sensory organisation test, reactive balance test and rhythmic weight shift test.

Results: No significant difference was observed between testing occasions for any of the balance measures investigated (p > 0.05).

Conclusion: Our results suggest that use of a Nintendo Wii balance board and Wii Fit software for a minimum of thirty minutes per day in the patient's own home, over a five week period, is not effective as a balance training tool in children with cerebral palsy.

Keywords:  Balance, postural stability, interactive games, Nintendo Wii, cerebral palsy, children

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Wednesday, 2 January 2013

Wii-habilitation as balance therapy for children with acquired brain injury.

Authors: Tatla SK, Radomski A, Cheung J, Maron M, Jarus T.

Developmental Neurorehabilation. 2012 Dec 11. [Epub ahead of print]

Acute Rehabilitation Team, Sunny Hill Health Centre for Children, 3644 Slocan Avenue , Vancouver, BC V5M 3E8 , Canada.

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Purpose: To evaluate the effectiveness of the Nintendo Wii compared to traditional balance therapy in improving balance, motivation, and functional ability in children undergoing acute rehabilitation after brain injury.
Methods: A non-concurrent, randomized multiple baseline single-subject research design was used with three participants. Data were analyzed by visual inspection of trend lines.
Results: Daily Wii balance training was equally motivating to traditional balance therapy for two participants and more motivating for one participant. While improvements in dynamic balance were observed, the results for static balance remain inconclusive. All participants demonstrated improvements in functional ability.
Conclusion: Wii balance therapy is a safe, feasible, and motivating intervention for children undergoing acute rehabilitation after an acquired brain injury. Further research to examine the effectiveness of Wii balance therapy in this population is warranted.

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Tuesday, 1 January 2013

The assessment of postural control and the influence of a secondary task in people with anterior cruciate ligament reconstructed knees using a Nintendo Wii Balance Board.

British Journal of Sports Medicine. 2012 Dec 25. [Epub ahead of print]

Howells BE, Clark RA, Ardern CL, Bryant AL, Feller JA, Whitehead TS, Webster KE.

Source Musculoskeletal Research Centre, Faculty of Health Sciences, La Trobe University, Melbourne, Victoria, Australia.

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Postural control impairments may persist following anterior cruciate ligament (ACL) reconstruction. The effect of a secondary task on postural control has, however, not been determined. The purpose of this case-control study was to compare postural control in patients following ACL reconstruction with healthy individuals with and without a secondary task. 
45 patients (30 men and 15 women) participated at least 6 months following primary ACL reconstruction surgery. Participants were individually matched by age, gender and sports activity to healthy controls. 
Postural control was measured using a Nintendo Wii Balance Board and customised software during static single-leg stance and with the addition of a secondary task. The secondary task required participants to match the movement of an oscillating marker by adducting and abducting their arm. 
Centre of pressure (CoP) path length in both medial-lateral and anterior-posterior directions, and CoP total path length.


When compared with the control group, the anterior-posterior path length significantly increased in the ACL reconstruction patients' operated (12.3%, p=0.02) and non-operated limbs (12.8%, p=0.02) for the single-task condition, and the non-operated limb (11.5%, p=0.006) for the secondary task condition. The addition of a secondary task significantly increased CoP path lengths in all measures (p<0.001), although the magnitude of the increase was similar in both the ACL reconstruction and control groups.


ACL reconstruction patients showed a reduced ability in both limbs to control the movement of the body in the anterior-posterior direction. The secondary task affected postural control by comparable amounts in patients after ACL reconstruction and healthy controls. Devices for the objective measurement of postural control, such as the one used in this study, may help clinicians to more accurately identify patients with deficits who may benefit from targeted neuromuscular training programs.

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