Tuesday, 5 February 2013

The effect of Nintendo(R) Wii(R) on balance in people with multiple sclerosis: a pilot randomized control study.

Multiple Sclerosis. 2013 Jan 15. [Epub ahead of print]

Brichetto G, Spallarossa P, de Carvalho ML, Battaglia MA.

Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy.

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Improvement of sensory strategies is a relevant part of balance rehabilitation in multiple sclerosis (MS). This study aimed to Assess the effectiveness of visual-feedback exercises in improving balance in MS. We divided 36 patients into Wii and control-treated groups that underwent balance rehabilitation. Outcomes were obtained for Berg Balance Scale (BBS), Modified Fatigue Impact Scale, and sway area under conditions of opened and closed eyes. BBS showed a statistically significant improvement (from 49.6 to 54.6 points, p < 0.05) in the Wii group. Interactive visual-feedback exercises such as Wii could be more effective than the current standard protocol in improving balance disorders in MS.

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Monday, 4 February 2013

Energy cost of common activities in children and adolescents.

Journal of Physical Activity and Health. 2013 Jan;10(1):62-9.

Lyden K, Kozey Keadle S, Staudenmayer J, Freedson P, Alhassan S.
Dept of Kinesiology, University of Massachusetts-Amherst.

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BACKGROUND: The Compendium of Energy Expenditures for Youth assigns MET values to a wide range of activities. However, only 35% of activity MET values were derived from energy cost data measured in youth; the remaining activities were estimated from adult values.

PURPOSE: To determine the energy cost of common activities performed by children and adolescents and compare these data to similar activities reported in the compendium.

METHODS: Thirty-two children (8-11 years old) and 28 adolescents (12-16 years) completed 4 locomotion activities on a treadmill (TRD) and 5 age-specific activities of daily living (ADL). Oxygen consumption was measured using a portable metabolic analyzer.

RESULTS: In children, measured METs were significantly lower than compendium METs for 3 activities [basketball, bike riding, and Wii tennis (1.1-3.5 METs lower)]. In adolescents, measured METs were significantly lower than compendium METs for 4 ADLs [basketball, bike riding, board games, and Wii tennis (0.3-2.5 METs lower)] and 3 TRDs [2.24 m·s-1, 1.56 m·s-1, and 1.34 m·s-1 (0.4-0.8 METs lower)].

CONCLUSION: The Compendium of Energy Expenditures for Youth is an invaluable resource to applied researchers. Inclusion of empirically derived data would improve the validity of the Compendium of Energy Expenditures for Youth.

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Integrating virtual reality video games into practice: Clinicians' experiences.

Posted online on January 30, 2013.

Danielle E. Levac, PT, PhD and Patricia A. Miller, PT, PhD

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The Nintendo Wii is a popular virtual reality (VR) video gaming system in rehabilitation practice and research. As evidence emerges related to its effectiveness as a physical therapy training method, clinicians require information about the pragmatics of its use in practice. The purpose of this descriptive qualitative study is to explore observations and insights from a sample of physical therapists (PTs) working with children with acquired brain injury regarding practical implications of using the Wii as a physical therapy intervention. Six PTs employed at a children's rehabilitation center participated in semi-structured interviews, which were transcribed and analyzed using content analysis. Two themes summarize the practical implications of Wii use: 1) technology meets clinical practice; and 2) onus is on the therapist. Therapists described both beneficial and challenging implications arising from the intersection of technology and practice, and reported the personal commitment required to orient oneself to the gaming system and capably implement this intervention. Findings include issues that may be relevant to professional development in a broader rehabilitation context, including suggestions for the content of educational initiatives and the need for institutional support from managers in the form of physical resources for VR implementation.

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An investigation of the impact of regular use of the Wii Fit to improve motor and psychosocial outcomes in children with movement difficulties: a pilot study.

Child Care Health Dev. 2013 Jan 30. [Epub ahead of print]

Hammond J, Jones V, Hill EL, Green D, Male I.

Brighton & Sussex Medical School, University of Sussex, Brighton, East Sussex, UK.

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BACKGROUND: Children with Developmental Co-ordination Disorder (DCD) experience poor motor and psychosocial outcomes. Interventions are often limited within the healthcare system, and little is known about how technology might be used within schools or homes to promote the motor skills and/or psychosocial development of these children. This study aimed to evaluate whether short, regular school-based sessions of movement experience using a commercially available home video game console (Nintendo's Wii Fit) would lead to benefits in both motor and psychosocial domains in children with DCD.

METHODS: A randomized crossover controlled trial of children with movement difficulties/DCD was conducted. Children were randomly assigned to an intervention (n = 10) or comparison (n = 8) group. The intervention group spent 10 min thrice weekly for 1 month using Wii Fit during the lunch break, while the comparison group took part in their regular Jump Ahead programme. Pre- and post-intervention assessments considered motor proficiency, self-perceived ability and satisfaction and parental assessment of emotional and behavioural problems.

RESULTS: Significant gains were seen in motor proficiency, the child's perception of his/her motor ability and reported emotional well-being for many, but not all children.

CONCLUSIONS: This study provides preliminary evidence to support the use of the Wii Fit within therapeutic programmes for children with movement difficulties. This simple, popular intervention represents a plausible method to support children's motor and psychosocial development. It is not possible from our data to say which children are most likely to benefit from such a programme and particularly what the dose and duration should be. Further research is required to inform across these and other questions regarding the implementation of virtual reality technologies in therapeutic services for children with movement difficulties.

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