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.
+/- Click for more/less
Showing posts with label motor learning. Show all posts
Showing posts with label motor learning. Show all posts
Monday, 4 February 2013
Wednesday, 24 October 2012
Motor learning, retention and transfer after virtual-reality-based training in Parkinson's disease--effect of motor and cognitive demands of games: a longitudinal, controlled clinical study.
Physiotherapy. 2012 Sep;98(3):217-23.
Epub 2012 Jul 9.
dos Santos Mendes FA, Pompeu JE, Modenesi Lobo A, Guedes da Silva K, Oliveira Tde P, Peterson Zomignani A, Pimentel Piemonte ME.
Department of Neuroscience and Behaviour, Institute of Psychology, University of São Paulo, São Paulo, Brazil.
+/- Click for more/less
Abstract
OBJECTIVES: To evaluate the learning, retention and transfer of performance improvements after Nintendo Wii Fit™ training in patients with Parkinson's disease and healthy elderly people.
DESIGN: Longitudinal, controlled clinical study.
PARTICIPANTS: Sixteen patients with early-stage Parkinson's disease and 11 healthy elderly people.
INTERVENTIONS: Warm-up exercises and Wii Fit training that involved training motor (shifts centre of gravity and step alternation) and cognitive skills. A follow-up evaluative Wii Fit session was held 60 days after the end of training. Participants performed a functional reach test before and after training as a measure of learning transfer.
MAIN OUTCOME MEASURES: Learning and retention were determined based on the scores of 10 Wii Fit games over eight sessions. Transfer of learning was assessed after training using the functional reach test.
RESULTS: Patients with Parkinson's disease showed no deficit in learning or retention on seven of the 10 games, despite showing poorer performance on five games compared with the healthy elderly group. Patients with Parkinson's disease showed marked learning deficits on three other games, independent of poorer initial performance. This deficit appears to be associated with cognitive demands of the games which require decision-making, response inhibition, divided attention and working memory. Finally, patients with Parkinson's disease were able to transfer motor ability trained on the games to a similar untrained task.
CONCLUSIONS: The ability of patients with Parkinson's disease to learn, retain and transfer performance improvements after training on the Nintendo Wii Fit depends largely on the demands, particularly cognitive demands, of the games involved, reiterating the importance of game selection for rehabilitation purposes.
Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
Click here for more information
dos Santos Mendes FA, Pompeu JE, Modenesi Lobo A, Guedes da Silva K, Oliveira Tde P, Peterson Zomignani A, Pimentel Piemonte ME.
Department of Neuroscience and Behaviour, Institute of Psychology, University of São Paulo, São Paulo, Brazil.
+/- Click for more/less
Abstract
OBJECTIVES: To evaluate the learning, retention and transfer of performance improvements after Nintendo Wii Fit™ training in patients with Parkinson's disease and healthy elderly people.
DESIGN: Longitudinal, controlled clinical study.
PARTICIPANTS: Sixteen patients with early-stage Parkinson's disease and 11 healthy elderly people.
INTERVENTIONS: Warm-up exercises and Wii Fit training that involved training motor (shifts centre of gravity and step alternation) and cognitive skills. A follow-up evaluative Wii Fit session was held 60 days after the end of training. Participants performed a functional reach test before and after training as a measure of learning transfer.
MAIN OUTCOME MEASURES: Learning and retention were determined based on the scores of 10 Wii Fit games over eight sessions. Transfer of learning was assessed after training using the functional reach test.
RESULTS: Patients with Parkinson's disease showed no deficit in learning or retention on seven of the 10 games, despite showing poorer performance on five games compared with the healthy elderly group. Patients with Parkinson's disease showed marked learning deficits on three other games, independent of poorer initial performance. This deficit appears to be associated with cognitive demands of the games which require decision-making, response inhibition, divided attention and working memory. Finally, patients with Parkinson's disease were able to transfer motor ability trained on the games to a similar untrained task.
CONCLUSIONS: The ability of patients with Parkinson's disease to learn, retain and transfer performance improvements after training on the Nintendo Wii Fit depends largely on the demands, particularly cognitive demands, of the games involved, reiterating the importance of game selection for rehabilitation purposes.
Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
Click here for more information
Saturday, 29 October 2011
Virtual reality for stroke rehabilitation - Review
Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd
Kate E Laver, Stacey George, Susie Thomas, Judith E Deutsch, Maria Crotty
+/- Click for more/less
Abstract
Background
Virtual reality and interactive video gaming have emerged as new treatment approaches in stroke rehabilitation. In particular, commercial gaming consoles are being rapidly adopted in clinical settings; however, there is currently little information about their effectiveness.
Objectives
To evaluate the effects of virtual reality and interactive video gaming on upper limb, lower limb and global motor function after stroke.
Search strategy
We searched the Cochrane Stroke Group Trials Register (March 2010), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2010, Issue 1), MEDLINE (1950 to March 2010), EMBASE (1980 to March 2010) and seven additional databases. We also searched trials registries, conference proceedings, reference lists and contacted key researchers in the area and virtual reality equipment manufacturers.
Selection criteria
Randomised and quasi-randomised trials of virtual reality ('an advanced form of human-computer interface that allows the user to 'interact' with and become 'immersed' in a computer-generated environment in a naturalistic fashion') in adults after stroke. The primary outcomes of interest were: upper limb function and activity, gait and balance function and activity and global motor function.
Data collection and analysis
Two review authors independently selected trials based on pre-defined inclusion criteria, extracted data and assessed risk of bias. A third review author moderated disagreements when required. The authors contacted all investigators to obtain missing information.
Main results
We included 19 trials which involved 565 participants. Study sample sizes were generally small and interventions and outcome measures varied, limiting the ability to which studies could be compared. Intervention approaches in the included studies were predominantly designed to improve motor function rather than cognitive function or activity performance. The majority of participants were relatively young and more than one year post stroke. Primary outcomes: results were statistically significant for arm function (standardised mean difference (SMD) 0.53, 95% confidence intervals (CI) 0.25 to 0.81 based on seven studies with 205 participants). There were no statistically significant effects for grip strength or gait speed. We were unable to determine the effect on global motor function due to insufficient numbers of comparable studies. Secondary outcomes: results were statistically significant for activities of daily living (ADL) outcome (SMD 0.81, 95% CI 0.39 to 1.22 based on three studies with 101 participants); however, we were unable to pool results for cognitive function, participation restriction and quality of life or imaging studies. There were few adverse events reported across studies and those reported were relatively mild. Studies that reported on eligibility rates showed that only 34% (standard deviation (SD) 26, range 17 to 80) of participants screened were recruited.
Authors' conclusions
We found limited evidence that the use of virtual reality and interactive video gaming may be beneficial in improving arm function and ADL function when compared with the same dose of conventional therapy. There was insufficient evidence to reach conclusions about the effect of virtual reality and interactive video gaming on grip strength or gait speed. It is unclear at present which characteristics of virtual reality are most important and it is unknown whether effects are sustained in the longer term. Furthermore, there are currently very few studies evaluating the use of commercial gaming consoles (such as the Nintendo Wii).
Click here for more
Kate E Laver, Stacey George, Susie Thomas, Judith E Deutsch, Maria Crotty
+/- Click for more/less
Abstract
Background
Virtual reality and interactive video gaming have emerged as new treatment approaches in stroke rehabilitation. In particular, commercial gaming consoles are being rapidly adopted in clinical settings; however, there is currently little information about their effectiveness.
Objectives
To evaluate the effects of virtual reality and interactive video gaming on upper limb, lower limb and global motor function after stroke.
Search strategy
We searched the Cochrane Stroke Group Trials Register (March 2010), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2010, Issue 1), MEDLINE (1950 to March 2010), EMBASE (1980 to March 2010) and seven additional databases. We also searched trials registries, conference proceedings, reference lists and contacted key researchers in the area and virtual reality equipment manufacturers.
Selection criteria
Randomised and quasi-randomised trials of virtual reality ('an advanced form of human-computer interface that allows the user to 'interact' with and become 'immersed' in a computer-generated environment in a naturalistic fashion') in adults after stroke. The primary outcomes of interest were: upper limb function and activity, gait and balance function and activity and global motor function.
Data collection and analysis
Two review authors independently selected trials based on pre-defined inclusion criteria, extracted data and assessed risk of bias. A third review author moderated disagreements when required. The authors contacted all investigators to obtain missing information.
Main results
We included 19 trials which involved 565 participants. Study sample sizes were generally small and interventions and outcome measures varied, limiting the ability to which studies could be compared. Intervention approaches in the included studies were predominantly designed to improve motor function rather than cognitive function or activity performance. The majority of participants were relatively young and more than one year post stroke. Primary outcomes: results were statistically significant for arm function (standardised mean difference (SMD) 0.53, 95% confidence intervals (CI) 0.25 to 0.81 based on seven studies with 205 participants). There were no statistically significant effects for grip strength or gait speed. We were unable to determine the effect on global motor function due to insufficient numbers of comparable studies. Secondary outcomes: results were statistically significant for activities of daily living (ADL) outcome (SMD 0.81, 95% CI 0.39 to 1.22 based on three studies with 101 participants); however, we were unable to pool results for cognitive function, participation restriction and quality of life or imaging studies. There were few adverse events reported across studies and those reported were relatively mild. Studies that reported on eligibility rates showed that only 34% (standard deviation (SD) 26, range 17 to 80) of participants screened were recruited.
Authors' conclusions
We found limited evidence that the use of virtual reality and interactive video gaming may be beneficial in improving arm function and ADL function when compared with the same dose of conventional therapy. There was insufficient evidence to reach conclusions about the effect of virtual reality and interactive video gaming on grip strength or gait speed. It is unclear at present which characteristics of virtual reality are most important and it is unknown whether effects are sustained in the longer term. Furthermore, there are currently very few studies evaluating the use of commercial gaming consoles (such as the Nintendo Wii).
Click here for more
Thursday, 5 August 2010
Brain activity in goal-directed movements in a real compared to a virtual environment using the Nintendo Wii.
Baumeister J, Reinecke K, Cordes M, Lerch C, Weiss M.
Exercise & Brain Lab, Institute of Sports Medicine, Department of Exercise & Health, University of Paderborn, Warburger Str. 100, 33098 Paderborn, Germany. jochen@sportmed.upb.de
Neurosci Lett. 2010 Aug 30;481(1):47-50. Epub 2010 Jun 25.
+/- Click for more/less
Abstract
Low budget virtual environments like the Nintendo Wii increased in popularity and may play a role in motor learning related to sports and exercise. But nothing was known about the comparability of cortical activity of motor tasks in real and virtual environments. The aim of the study was to examine cortical differences between real and Wii based virtual sports performances using the golf putt as a model. Ten male golfers (26.0 +/- 0.7 years; 81.8 +/- 5.6 kg; 184.5 +/- 6.0 cm; handicap 30.0+/-10.0; 2.9+/-1.0 years of golf experience) were asked to putt for 3 min in random order in the real and the virtual Wii condition. A rest in sitting position (3 min) followed each performance. The score and cortical activity (EEG) were recorded continuously. The participants performed with a significant better score in the real condition (p < or = 0.01). Compared to virtual putting Theta spectral power showed a significant increase during real performance at F3 and F4 (p < or = 0.05). Significantly increased Alpha-2 power was demonstrated during real putting compared to the virtual putting performance at P3 (p < or = 0.05). The findings suggested that putting performance and brain activity was influenced by the choice of a real or virtual environment. The results were discussed based on the concept of the working memory where increased frontal Theta power indicated higher focused attention and higher Alpha-2 power was inversely related to the quantity of sensory information processing in the real putting compared to the virtual condition. 2010 Elsevier Ireland Ltd. All rights reserved. More
Exercise & Brain Lab, Institute of Sports Medicine, Department of Exercise & Health, University of Paderborn, Warburger Str. 100, 33098 Paderborn, Germany. jochen@sportmed.upb.de
Neurosci Lett. 2010 Aug 30;481(1):47-50. Epub 2010 Jun 25.
+/- Click for more/less
Abstract
Low budget virtual environments like the Nintendo Wii increased in popularity and may play a role in motor learning related to sports and exercise. But nothing was known about the comparability of cortical activity of motor tasks in real and virtual environments. The aim of the study was to examine cortical differences between real and Wii based virtual sports performances using the golf putt as a model. Ten male golfers (26.0 +/- 0.7 years; 81.8 +/- 5.6 kg; 184.5 +/- 6.0 cm; handicap 30.0+/-10.0; 2.9+/-1.0 years of golf experience) were asked to putt for 3 min in random order in the real and the virtual Wii condition. A rest in sitting position (3 min) followed each performance. The score and cortical activity (EEG) were recorded continuously. The participants performed with a significant better score in the real condition (p < or = 0.01). Compared to virtual putting Theta spectral power showed a significant increase during real performance at F3 and F4 (p < or = 0.05). Significantly increased Alpha-2 power was demonstrated during real putting compared to the virtual putting performance at P3 (p < or = 0.05). The findings suggested that putting performance and brain activity was influenced by the choice of a real or virtual environment. The results were discussed based on the concept of the working memory where increased frontal Theta power indicated higher focused attention and higher Alpha-2 power was inversely related to the quantity of sensory information processing in the real putting compared to the virtual condition. 2010 Elsevier Ireland Ltd. All rights reserved. More
Wednesday, 21 July 2010
Effectiveness of Virtual Reality Exercises in Stroke Rehabilitation (EVREST) (2010)
+/- Click for more/less
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.
Subscribe to:
Posts (Atom)
Abstract
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.
Click for more information