Clinical Rehabilitation 2012 Sept 7 (Epub ahead of print)
Holmes JD, Jenkins ME, Johnson AM, Hunt MA, Clark RA.
School of Occupational Therapy, The University of Western Ontario, Canada.
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Showing posts with label assessment. Show all posts
Showing posts with label assessment. Show all posts
Thursday, 20 September 2012
Sunday, 6 May 2012
Virtual reality rehabilitation of balance: assessment of the usability of the Nintendo Wii® Fit Plus, Disability and Rehabilitation
Disability and Rehabilitation: Assistive Technology
May 2012, Vol. 7, No. 3 , Pages 205-210
Dara Meldrum, Aine Glennon1, Susan Herdman, Deirdre Murray, Rory McConn-Walsh
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May 2012, Vol. 7, No. 3 , Pages 205-210
Dara Meldrum, Aine Glennon1, Susan Herdman, Deirdre Murray, Rory McConn-Walsh
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Abstract:
Purpose: The aim of this study was to investigate the usability of the Nintendo Wii Fit Plus® (NWFP) in the treatment of balance impairment in vestibular and other neurological disease.
Methods: This was a cross-sectional, quasi-experimental study. Participants (n = 26; mean age 43 ± 14, M13:F13) with quantified balance impairment took part in a 30-minute session on the NWFP using exercises and games that challenge balance. Outcomes included the System Usability Scale (SUS), a numerical rating scale of enjoyment and a post treatment questionnaire.
Results: The mean SUS score was high (mean 82 ± 18%) with only two participants rating below 50%. There was a negative correlation of age with SUS scores (r = −0.54; p = 0.004). Mean numerical rating scale score (/10) for enjoyment of the NWFP session was 8.4 ± 3. Of the participants, 88.5% said that they would like to use the NWFP in future treatment. Seventy-three percent reported more enjoyment and motivation than usual physiotherapy. No falls occurred during testing.
Conclusions: This study has quantified the usability of the NWFP as a treatment for balance impairment showing high levels of usability and enjoyment with no serious adverse effects. The results of this study may assist physiotherapists in devising novel balance rehabilitation programmes.
Implications for Rehabilitation
The Nintendo Wii Fit Plus® virtual reality system has the potential to improve balance rehabilitation, but usability of this system requires investigation.
In this study, patients with balance impairment as a result of neurological disease reported very high levels of usability and enjoyment when performing selected Nintendo Wii Fit Plus® balance exercises and games.
The majority of patients preferred the Nintendo Wii Fit Plus to conventional treatment which may have implications for patient compliance with exercise.
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Purpose: The aim of this study was to investigate the usability of the Nintendo Wii Fit Plus® (NWFP) in the treatment of balance impairment in vestibular and other neurological disease.
Methods: This was a cross-sectional, quasi-experimental study. Participants (n = 26; mean age 43 ± 14, M13:F13) with quantified balance impairment took part in a 30-minute session on the NWFP using exercises and games that challenge balance. Outcomes included the System Usability Scale (SUS), a numerical rating scale of enjoyment and a post treatment questionnaire.
Results: The mean SUS score was high (mean 82 ± 18%) with only two participants rating below 50%. There was a negative correlation of age with SUS scores (r = −0.54; p = 0.004). Mean numerical rating scale score (/10) for enjoyment of the NWFP session was 8.4 ± 3. Of the participants, 88.5% said that they would like to use the NWFP in future treatment. Seventy-three percent reported more enjoyment and motivation than usual physiotherapy. No falls occurred during testing.
Conclusions: This study has quantified the usability of the NWFP as a treatment for balance impairment showing high levels of usability and enjoyment with no serious adverse effects. The results of this study may assist physiotherapists in devising novel balance rehabilitation programmes.
Implications for Rehabilitation
The Nintendo Wii Fit Plus® virtual reality system has the potential to improve balance rehabilitation, but usability of this system requires investigation.
In this study, patients with balance impairment as a result of neurological disease reported very high levels of usability and enjoyment when performing selected Nintendo Wii Fit Plus® balance exercises and games.
The majority of patients preferred the Nintendo Wii Fit Plus to conventional treatment which may have implications for patient compliance with exercise.
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Monday, 6 June 2011
Assisting people with multiple disabilities by actively keeping the head in an upright position with a Nintendo Wii Remote Controller through the control of an environmental stimulation. May 2011
Res Dev Disabil.
2011 May 19.
Shih CH, Shih CJ, Shih CT.
Source: Department of Special Education, National Dong Hwa University, Hualien 970, Taiwan, ROC
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Abstract
The latest researches have adopted software technology by applying the Nintendo Wii Remote Controller to the correction of hyperactive limb behavior.
This study extended Wii Remote Controller functionality for improper head position (posture) correction (i.e. actively adjusting abnormal head posture) to assess whether two people with multiple disabilities would be able to actively keep the upright head position by controlling their favorite stimulation using a Wii Remote Controller with a newly developed active head position correcting program (AHPCP).
The study was performed according to an ABAB design, in which A represented the baseline and B represented intervention phases.
Results showed that both participants significantly increased their time duration of maintaining upright head position (TDMUHP) to obtain the desired environmental stimulation during the intervention phases.
Practical and developmental implications of the findings were discussed.
Copyright © 2011 Elsevier Ltd. All rights reserved.
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2011 May 19.
Shih CH, Shih CJ, Shih CT.
Source: Department of Special Education, National Dong Hwa University, Hualien 970, Taiwan, ROC
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Abstract
The latest researches have adopted software technology by applying the Nintendo Wii Remote Controller to the correction of hyperactive limb behavior.
This study extended Wii Remote Controller functionality for improper head position (posture) correction (i.e. actively adjusting abnormal head posture) to assess whether two people with multiple disabilities would be able to actively keep the upright head position by controlling their favorite stimulation using a Wii Remote Controller with a newly developed active head position correcting program (AHPCP).
The study was performed according to an ABAB design, in which A represented the baseline and B represented intervention phases.
Results showed that both participants significantly increased their time duration of maintaining upright head position (TDMUHP) to obtain the desired environmental stimulation during the intervention phases.
Practical and developmental implications of the findings were discussed.
Copyright © 2011 Elsevier Ltd. All rights reserved.
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Sunday, 5 June 2011
Reliability of an inexpensive and portable dynamic weight bearing asymmetry assessment system incorporating dual Nintendo Wii Balance Boards - May 2011
Gait Posture.
2011 May 11.
Clark RA, McGough R, Paterson K.
Source: Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, 202 Berkeley Street, Parkville, VIC 3010, Australia.
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Abstract
Weight bearing asymmetry (WBA) during dynamic tasks is prevalent in a variety of clinical populations. However, accurate measurement has previously been out of reach of the clinician due to the costly equipment and technical expertise required.
The aim of this study was to assess the test-retest reliability of WBA data obtained using an inexpensive and simple to use dual force plate system incorporating unmodified Nintendo Wii Balance Boards (NWBB) and customized software. A secondary outcome measure, individual limb COP path velocity, which represents the postural sway under each limb was also examined.
Twenty-three participants performed squats both with and without visual WBA feedback on two separate occasions. Weight-bearing asymmetry as a percentage of body mass and individual limb center of pressure (COP) path velocity were recorded during these trials, with intraclass correlation coefficient (ICC(2,1)) analysis performed to assess test-retest reliability. This system provided reliable values for both outcome measures when performed with and without real-time visual feedback of WBA (ICC(2,1) range=0.75-0.91).
In conclusion, recording WBA and COP path velocity data using NWBB is reliable. Given that tens of millions of NWBB have been sold worldwide, and that reprogramming them for clinical purposes is within the reach of most software developers, similar systems may soon become commonplace in the clinical setting.
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2011 May 11.
Clark RA, McGough R, Paterson K.
Source: Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, 202 Berkeley Street, Parkville, VIC 3010, Australia.
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Abstract
Weight bearing asymmetry (WBA) during dynamic tasks is prevalent in a variety of clinical populations. However, accurate measurement has previously been out of reach of the clinician due to the costly equipment and technical expertise required.
The aim of this study was to assess the test-retest reliability of WBA data obtained using an inexpensive and simple to use dual force plate system incorporating unmodified Nintendo Wii Balance Boards (NWBB) and customized software. A secondary outcome measure, individual limb COP path velocity, which represents the postural sway under each limb was also examined.
Twenty-three participants performed squats both with and without visual WBA feedback on two separate occasions. Weight-bearing asymmetry as a percentage of body mass and individual limb center of pressure (COP) path velocity were recorded during these trials, with intraclass correlation coefficient (ICC(2,1)) analysis performed to assess test-retest reliability. This system provided reliable values for both outcome measures when performed with and without real-time visual feedback of WBA (ICC(2,1) range=0.75-0.91).
In conclusion, recording WBA and COP path velocity data using NWBB is reliable. Given that tens of millions of NWBB have been sold worldwide, and that reprogramming them for clinical purposes is within the reach of most software developers, similar systems may soon become commonplace in the clinical setting.
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Thursday, 28 April 2011
The Reliability and Preliminary Validity of Game-Based Fall Risk Assessment in Community-Dwelling Older Adults.
Geriatric Nursing
2011 Apr 16. [Epub ahead of print]
Yamada M, Aoyama T, Nakamura M, Tanaka B, Nagai K, Tatematsu N, Uemura K, Nakamura T, Tsuboyama T, Ichihashi N.
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Abstract
The purpose of this study was to examine whether the Nintendo Wii Fit program could be used for fall risk assessment in healthy, community-dwelling older adults. Forty-five community-dwelling older women participated in this study. The "Basic Step" and "Ski Slalom" modules were selected from the Wii Fit game program. The following 5 physical performance tests were performed: the 10-m walk test under single- and dual-task conditions, the Timed Up and Go test under single- and dual-task conditions, and the Functional Reach test. Compared with the faller group, the nonfaller group showed a significant difference in the Basic Step (P < .001) and a nonsignificant difference in the Ski Slalom (P = .453). The discriminating criterion between the 2 groups was a score of 111 points on the Basic Step (P < .001). The Basic Step showed statistically significant, moderate correlations between the dual-task lag of walking (r = -.547) and the dual-task lag of the Timed Up and Go test (r = -.688). These results suggest that game-based fall risk assessment using the Basic Step has a high generality and is useful in community-dwelling older adults.
2011 Apr 16. [Epub ahead of print]
Yamada M, Aoyama T, Nakamura M, Tanaka B, Nagai K, Tatematsu N, Uemura K, Nakamura T, Tsuboyama T, Ichihashi N.
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Abstract
The purpose of this study was to examine whether the Nintendo Wii Fit program could be used for fall risk assessment in healthy, community-dwelling older adults. Forty-five community-dwelling older women participated in this study. The "Basic Step" and "Ski Slalom" modules were selected from the Wii Fit game program. The following 5 physical performance tests were performed: the 10-m walk test under single- and dual-task conditions, the Timed Up and Go test under single- and dual-task conditions, and the Functional Reach test. Compared with the faller group, the nonfaller group showed a significant difference in the Basic Step (P < .001) and a nonsignificant difference in the Ski Slalom (P = .453). The discriminating criterion between the 2 groups was a score of 111 points on the Basic Step (P < .001). The Basic Step showed statistically significant, moderate correlations between the dual-task lag of walking (r = -.547) and the dual-task lag of the Timed Up and Go test (r = -.688). These results suggest that game-based fall risk assessment using the Basic Step has a high generality and is useful in community-dwelling older adults.
Copyright © 2011 Mosby, Inc. All rights reserved.
Friday, 3 December 2010
Assessing and training standing balance in older adults: A novel approach using the 'Nintendo Wii' Balance Board.
Gait Posture. 2010 Nov 17. [Epub ahead of print]
Young W, Ferguson S, Brault S, Craig C.
The School of Psychology, The Queen's University Belfast
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Abstract
Older adults, deemed to be at a high risk of falling, are often unable to participate in dynamic exercises due to physical constraints and/or a fear of falling. Using the Nintendo 'Wii Balance Board' (WBB) (Nintendo, Kyoto, Japan), we have developed an interface that allows a user to accurately calculate a participant's centre of pressure (COP) and incorporate it into a virtual environment to create bespoke diagnostic or training programmes that exploit real-time visual feedback of current COP position. This platform allows researchers to design, control and validate tasks that both train and test balance function. This technology provides a safe, adaptable and low-cost balance training/testing solution for older adults, particularly those at high-risk of falling.
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Young W, Ferguson S, Brault S, Craig C.
The School of Psychology, The Queen's University Belfast
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Abstract
Older adults, deemed to be at a high risk of falling, are often unable to participate in dynamic exercises due to physical constraints and/or a fear of falling. Using the Nintendo 'Wii Balance Board' (WBB) (Nintendo, Kyoto, Japan), we have developed an interface that allows a user to accurately calculate a participant's centre of pressure (COP) and incorporate it into a virtual environment to create bespoke diagnostic or training programmes that exploit real-time visual feedback of current COP position. This platform allows researchers to design, control and validate tasks that both train and test balance function. This technology provides a safe, adaptable and low-cost balance training/testing solution for older adults, particularly those at high-risk of falling.
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Wednesday, 21 July 2010
Validity and reliability of the Nintendo Wii Balance Board for assessment of standing balance (2010)
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Gait & Posture, Volume 31, Issue 3, March 2010, Pages 307-310
Ross A. Clarka, Adam L. Bryanta, Yonghao Puab, Paul McCrorya, Kim Bennella and Michael Hunta
Abstract
Impaired standing balance has a detrimental effect on a person's functional ability and increases their risk of falling. There is currently no validated system which can precisely quantify center of pressure (COP), an important component of standing balance, while being inexpensive, portable and widely available. The Wii Balance Board (WBB) fits these criteria, and we examined its validity in comparison with the ‘gold standard’—a laboratory-grade force platform (FP). Thirty subjects without lower limb pathology performed a combination of single and double leg standing balance tests with eyes open or closed on two separate occasions. Data from the WBB were acquired using a laptop computer. The test–retest reliability for COP path length for each of the testing devices, including a comparison of the WBB and FP data, was examined using intraclass correlation coefficients (ICC), Bland–Altman plots (BAP) and minimum detectable change (MDC). Both devices exhibited good to excellent COP path length test–retest reliability within-device (ICC = 0.66–0.94) and between-device (ICC = 0.77–0.89) on all testing protocols. Examination of the BAP revealed no relationship between the difference and the mean in any test, however the MDC values for the WBB did exceed those of the FP in three of the four tests. These findings suggest that the WBB is a valid tool for assessing standing balance. Given that the WBB is portable, widely available and a fraction of the cost of a FP, it could provide the average clinician with a standing balance assessment tool suitable for the clinical setting.
Keywords: Balance; Motor control; Movement disorder; Rehabilitation; Force plate; Biomechanics; Gait; Posture
A new standing posture detector to enable people with multiple disabilities to control environmental stimulation by changing their standing posture through a commercial Wii Balance Board (2010)
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Research in Developmental Disabilities Volume 31, Issue 1, January-February 2010, Pages 281-286
Ching-Hsiang Shiha, Ching-Tien Shihb and Ming-Shan Chianga
Abstract
This study assessed whether two persons with multiple disabilities would be able to control environmental stimulation using body swing (changing standing posture) and a Wii Balance Board with a newly developed standing posture detection program (i.e. a new software program turns a WiiBalance Board into a precise standing posture detector). The study was performed according to an ABAB design, in which A represented baseline and B represented intervention phases. Both participants significantly increased their target response (body swing) to activate the control system to produce environmental stimulation during the intervention phases. Practical and developmental implications of the findings were discussed.
Keywords: Standing posture detector; Wii Balance Board; Multiple disabilities
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Research in Developmental Disabilities Volume 31, Issue 1, January-February 2010, Pages 281-286
Ching-Hsiang Shiha, Ching-Tien Shihb and Ming-Shan Chianga
Abstract
This study assessed whether two persons with multiple disabilities would be able to control environmental stimulation using body swing (changing standing posture) and a Wii Balance Board with a newly developed standing posture detection program (i.e. a new software program turns a WiiBalance Board into a precise standing posture detector). The study was performed according to an ABAB design, in which A represented baseline and B represented intervention phases. Both participants significantly increased their target response (body swing) to activate the control system to produce environmental stimulation during the intervention phases. Practical and developmental implications of the findings were discussed.
Keywords: Standing posture detector; Wii Balance Board; Multiple disabilities
Effectiveness of Virtual Reality Exercises in Stroke Rehabilitation (EVREST) (2010)
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Int J Stroke. 2010 Feb;5(1):47-51.
Saposnik G, Mamdani M, Bayley M, Thorpe KE, Hall J, Cohen LG, Teasell R; EVREST Steering Committee; EVREST Study Group for the Stroke Outcome Research Canada Working Group.
Abstract
BACKGROUND:
Evidence suggests that increasing intensity of rehabilitation results in better motor recovery. Limited evidence is available on the effectiveness of an interactive virtual reality gaming system for stroke rehabilitation. EVREST was designed to evaluate feasibility, safety and efficacy of using the Nintendo Wii gaming virtual reality (VRWii) technology to improve arm recovery in stroke patients.
METHODS:
Pilot randomized study comparing, VRWii versus recreational therapy (RT) in patients receiving standard rehabilitation within six months of stroke with a motor deficit of > or =3 on the Chedoke-McMaster Scale (arm). In this study we expect to randomize 20 patients. All participants (age 18-85) will receive customary rehabilitative treatment consistent of a standardized protocol (eight sessions, 60 min each, over a two-week period).
OUTCOME MEASURES:
The primary feasibility outcome is the total time receiving the intervention. The primary safety outcome is the proportion of patients experiencing intervention-related adverse events during the study period. Efficacy, a secondary outcome measure, will be measured by the Wolf Motor Function Test, Box and Block Test, and Stroke Impact Scale at the four-week follow-up visit. From November, 2008 to September, 2009 21 patients were randomized to VRWii or RT. Mean age, 61 (range 41-83) years. Mean time from stroke onset 25 (range 10-56) days.
CONCLUSIONS:
EVREST is the first randomized parallel controlled trial assessing the feasibility, safety, and efficacy of virtual reality using Wii gaming technology in stroke rehabilitation. The results of this study will serve as the basis for a larger multicentre trial.
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Abstract
Background:Impaired postural stability places individuals with Parkinson's at an increased risk for falls. Given the high incidence of fall-related injuries within this population, ongoing assessment of postural stability is important.
Objective:To evaluate the validity of the Nintendo Wii(®) balance board as a measurement tool for the assessment of postural stability in individuals with Parkinson's.
Subjects:Twenty individuals with Parkinson's participated.
Intervention:Subjects completed testing on two balance tasks with eyes open and closed on a Wii(®) balance board and biomechanical force platform.Main
Measures:Bland-Altman plots and a two-way, random-effects, single measure intraclass correlation coefficient model were used to assess concurrent validity of centre-of-pressure data.
Results:Concurrent validity was demonstrated to be excellent across balance tasks (intraclass correlation coefficients = 0.96, 0.98, 0.92, 0.94).
Conclusions:This study suggests that the Wii(®) balance board is a valid tool for the quantification of postural stability among individuals with Parkinson's.
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