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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Showing posts with label rehab. Show all posts
Showing posts with label rehab. Show all posts
Tuesday, 5 February 2013
Monday, 4 February 2013
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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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.
Click here for more information
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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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.
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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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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.
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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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Abstract:
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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Source: Abilities Neurological Rehabilitation, Vancouver, Canada
European Journal of Physical Rehabilitation Medicine. 2012 Nov 21.
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Abstract:
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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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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Abstract
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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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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Abstract
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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Abstract
BACKGROUND:
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.
PARTICIPANTS:
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.
MATERIALS:
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.
MAIN OUTCOME MEASURES:
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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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Abstract
BACKGROUND:
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.
PARTICIPANTS:
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.
MATERIALS:
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.
MAIN OUTCOME MEASURES:
Centre of pressure (CoP) path length in both medial-lateral and anterior-posterior directions, and CoP total path length.
RESULTS:
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.
DISCUSSION:
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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Tuesday, 18 September 2012
Potential of the Nintendo Wii™ as a rehabilitation tool for children with cerebral palsy in a developing country: a pilot study.
Physiotherapy. 2012 Sep;98(3):238-42. Epub 2012 Jul 23.
Gordon C, Roopchand-Martin S, Gregg A.
Source:Section of Physical Therapy, University of the West Indies, Kingston, Jamaica.
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Abstract
OBJECTIVES:
To explore the possibility of using the Nintendo Wii™ as a rehabilitation tool for children with cerebral palsy (CP) in a developing country, and determine whether there is potential for an impact on their gross motor function.
DESIGN:
Pilot study with a pre-post-test design.
SETTING:
Sir John Golding Rehabilitation Center, Jamaica, West Indies.
PARTICIPANTS:
Seven children, aged 6 to 12years, with dyskinetic CP were recruited for the study. One child dropped out at week 4.
INTERVENTION:
Training with the Nintendo Wii was conducted twice weekly for 6weeks. The games used were Wii Sports Boxing, Baseball and Tennis.
MAIN OUTCOME MEASURES:
Percentage attendance over the 6-week period, percentage of sessions for which the full duration of training was completed, and changes in gross motor function using the Gross Motor Function Measure (GMFM).
RESULTS:
All six participants who completed the study had 100% attendance, and all were able to complete the full 45minutes of training at every session. Those who were wheelchair bound participated in two games, whilst those who were ambulant played three games. The mean GMFM score increased from 62.83 [standard deviation (SD) 24.86] to 70.17 (SD 23.67).
CONCLUSION:
The Nintendo Wii has the potential for use as a rehabilitation tool in the management of children with CP. Clinical trials should be conducted in this area to determine whether this could be an effective tool for improving gross motor function.
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Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
Gordon C, Roopchand-Martin S, Gregg A.
Source:Section of Physical Therapy, University of the West Indies, Kingston, Jamaica.
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Abstract
OBJECTIVES:
To explore the possibility of using the Nintendo Wii™ as a rehabilitation tool for children with cerebral palsy (CP) in a developing country, and determine whether there is potential for an impact on their gross motor function.
DESIGN:
Pilot study with a pre-post-test design.
SETTING:
Sir John Golding Rehabilitation Center, Jamaica, West Indies.
PARTICIPANTS:
Seven children, aged 6 to 12years, with dyskinetic CP were recruited for the study. One child dropped out at week 4.
INTERVENTION:
Training with the Nintendo Wii was conducted twice weekly for 6weeks. The games used were Wii Sports Boxing, Baseball and Tennis.
MAIN OUTCOME MEASURES:
Percentage attendance over the 6-week period, percentage of sessions for which the full duration of training was completed, and changes in gross motor function using the Gross Motor Function Measure (GMFM).
RESULTS:
All six participants who completed the study had 100% attendance, and all were able to complete the full 45minutes of training at every session. Those who were wheelchair bound participated in two games, whilst those who were ambulant played three games. The mean GMFM score increased from 62.83 [standard deviation (SD) 24.86] to 70.17 (SD 23.67).
CONCLUSION:
The Nintendo Wii has the potential for use as a rehabilitation tool in the management of children with CP. Clinical trials should be conducted in this area to determine whether this could be an effective tool for improving gross motor function.
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Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
Monday, 23 July 2012
A game-console to improve balance in Parkinson Disease: preliminary results using the Nintendo Wii
Italian Journal of Physiotherapy 2012 June;2(2):45-9
Pelosin E., Avanzino L., Trompetto C., Marinelli L., Marchese R., Abbruzzese G.
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Pelosin E., Avanzino L., Trompetto C., Marinelli L., Marchese R., Abbruzzese G.
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Abstract:
AIM: Balance impairment is a common problem in idiopathic Parkinson’s disease (PD) often responsible for increased risk of falls, mobility restriction and loss of independence. Conventional exercises are often repetitive and may induce patients to lose their interest and to interrupt physical therapy at home. This study was aimed at evaluating theeffect of 5 days training with a low-cost, commercially available playing system, the Nintendo Wii® (NW), in improving balance in PD.
METHODS: Ten patients with PD and ten aged-match normal subjects (NS) were recruited and performed 30 minutes exercises playing with NW every day for one week. Subjects were evaluated by means of static posturography and Berg Balance Scale (BBS) before and after training.
RESULTS: The 5-day training, based on video-game system, induced a significant decrease in all the posturographic parameters in both groups improving postural stability of PD to a level comparable to baseline condition in NS. BBS score improved after training in PD patients.
CONCLUSION: These preliminary results suggest that a video game-based approach can exert a positive effect improving postural stability in PD patients. Because the NW device promotes better compliance, has wide applicability and is enjoyable to use, this treatment concept holds promise for PD rehabilitation
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AIM: Balance impairment is a common problem in idiopathic Parkinson’s disease (PD) often responsible for increased risk of falls, mobility restriction and loss of independence. Conventional exercises are often repetitive and may induce patients to lose their interest and to interrupt physical therapy at home. This study was aimed at evaluating theeffect of 5 days training with a low-cost, commercially available playing system, the Nintendo Wii® (NW), in improving balance in PD.
METHODS: Ten patients with PD and ten aged-match normal subjects (NS) were recruited and performed 30 minutes exercises playing with NW every day for one week. Subjects were evaluated by means of static posturography and Berg Balance Scale (BBS) before and after training.
RESULTS: The 5-day training, based on video-game system, induced a significant decrease in all the posturographic parameters in both groups improving postural stability of PD to a level comparable to baseline condition in NS. BBS score improved after training in PD patients.
CONCLUSION: These preliminary results suggest that a video game-based approach can exert a positive effect improving postural stability in PD patients. Because the NW device promotes better compliance, has wide applicability and is enjoyable to use, this treatment concept holds promise for PD rehabilitation
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Wednesday, 6 June 2012
Comparison between Nintendo Wii Fit and conventional rehabilitation on functional performance outcomes after hamstring anterior cruciate ligament reconstruction
KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
2012
Gul Baltaci, Gulcan Harput, Bunyamin Haksever, Burak Ulusoy andHamza Ozer
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Abstract
Purpose
The aim of this prospective, randomized, controlled, double-blind clinical trial was to compare the outcomes, including knee strength, balance, coordination, proprioception and response time, of Nintendo Wii Fit with those of conventional rehabilitation on the subjects with anterior cruciate ligament reconstruction.
Methods Thirty volunteer subjects were enrolled in either Wii Fit (n = 15; mean age, 29 ± 7 years) or conventional rehabilitation (n = 15; mean age, 29 ± 6 years) programmes from the first week up to 12th weeks of the operation. Endoscopic reconstruction of a completely ruptured ACL was performed by using graft harvested from hamstrings. Each subject underwent an individual therapeutic programme. Functional examinations included the measurements of the balance using modified star excursion balance test, coordination, proprioception and response time using functional squat system and strength of flexor and extensor muscles of the involved and uninvolved leg using an isokinetic machine.
Results There was no significant difference between Wii Fit and conventional group in terms of isokinetic knee strength at 12th week, and dynamic balance, and functional squat tests including coordination, proprioception and response time at first, 8th and 12th weeks of the rehabilitation.
Conclusion Two different 12-week-physiotherapy programmes following ACL reconstruction have the same affect on muscle strength, dynamic balance and functional performance values in both groups. We considered that the practice of Wii Fit activities like conventional rehabilitation could also address physical therapy goals, which included improving visual–perceptual processing, coordination, proprioception and functional mobility.
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Gul Baltaci, Gulcan Harput, Bunyamin Haksever, Burak Ulusoy andHamza Ozer
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Abstract
Purpose
The aim of this prospective, randomized, controlled, double-blind clinical trial was to compare the outcomes, including knee strength, balance, coordination, proprioception and response time, of Nintendo Wii Fit with those of conventional rehabilitation on the subjects with anterior cruciate ligament reconstruction.
Methods Thirty volunteer subjects were enrolled in either Wii Fit (n = 15; mean age, 29 ± 7 years) or conventional rehabilitation (n = 15; mean age, 29 ± 6 years) programmes from the first week up to 12th weeks of the operation. Endoscopic reconstruction of a completely ruptured ACL was performed by using graft harvested from hamstrings. Each subject underwent an individual therapeutic programme. Functional examinations included the measurements of the balance using modified star excursion balance test, coordination, proprioception and response time using functional squat system and strength of flexor and extensor muscles of the involved and uninvolved leg using an isokinetic machine.
Results There was no significant difference between Wii Fit and conventional group in terms of isokinetic knee strength at 12th week, and dynamic balance, and functional squat tests including coordination, proprioception and response time at first, 8th and 12th weeks of the rehabilitation.
Conclusion Two different 12-week-physiotherapy programmes following ACL reconstruction have the same affect on muscle strength, dynamic balance and functional performance values in both groups. We considered that the practice of Wii Fit activities like conventional rehabilitation could also address physical therapy goals, which included improving visual–perceptual processing, coordination, proprioception and functional mobility.
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Sunday, 6 May 2012
Effectiveness of conventional versus virtual reality based vestibular rehabilitation in the treatment of dizziness, gait and balance impairment in adults with unilateral peripheral vestibular loss: a randomised controlled trial
BMC Ear, Nose and Throat Disorders
Published: 26 March 2012
Dara Meldrum, Susan Herdman, Roisin Moloney, Deirdre Murray, Douglas Duffy, Kareena Malone, Helen French, Stephen Hone, Ronan Conroy and Rory McConn Walsh
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Background
Unilateral peripheral vestibular loss results in gait and balance impairment, dizziness and oscillopsia. Vestibular rehabilitation benefits patients but optimal treatment remains unkown. Virtual reality is an emerging tool in rehabilitation and provides opportunities to improve both outcomes and patient satisfaction with treatment. The Nintendo Wii Fit Plus (R) (NWFP) is a low cost virtual reality system that challenges balance and provides visual and auditory feedback. It may augment the motor learning that is required to improve balance and gait, but no trials to date have investigated efficacy.
Methods
In a single (assessor) blind, two centre randomised controlled superiority trial, 80 patients with unilateral peripheral vestibular loss will be randomised to either conventional or virtual reality based (NWFP) vestibular rehabilitation for 6 weeks. The primary outcome measure is gait speed (measured with three dimensional gait analysis). Secondary outcomes include computerised posturography, dynamic visual acuity, and validated questionnaires on dizziness, confidence and anxiety/depression. Outcome will be assessed post treatment (8 weeks) and at 6 months.
Discussion
Advances in the gaming industry have allowed mass production of highly sophisticated low cost virtual reality systems that incorporate technology previously not accessible to most therapists and patients. Importantly, they are not confined to rehabilitation departments, can be used at home and provide an accurate record of adherence to exercise. The benefits of providing augmented feedback, increasing intensity of exercise and accurately measuring adherence may improve conventional vestibular rehabilitation but efficacy must first be demonstrated.
Provisional PDF of article here Click here for more information
Dara Meldrum, Susan Herdman, Roisin Moloney, Deirdre Murray, Douglas Duffy, Kareena Malone, Helen French, Stephen Hone, Ronan Conroy and Rory McConn Walsh
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Background
Unilateral peripheral vestibular loss results in gait and balance impairment, dizziness and oscillopsia. Vestibular rehabilitation benefits patients but optimal treatment remains unkown. Virtual reality is an emerging tool in rehabilitation and provides opportunities to improve both outcomes and patient satisfaction with treatment. The Nintendo Wii Fit Plus (R) (NWFP) is a low cost virtual reality system that challenges balance and provides visual and auditory feedback. It may augment the motor learning that is required to improve balance and gait, but no trials to date have investigated efficacy.
Methods
In a single (assessor) blind, two centre randomised controlled superiority trial, 80 patients with unilateral peripheral vestibular loss will be randomised to either conventional or virtual reality based (NWFP) vestibular rehabilitation for 6 weeks. The primary outcome measure is gait speed (measured with three dimensional gait analysis). Secondary outcomes include computerised posturography, dynamic visual acuity, and validated questionnaires on dizziness, confidence and anxiety/depression. Outcome will be assessed post treatment (8 weeks) and at 6 months.
Discussion
Advances in the gaming industry have allowed mass production of highly sophisticated low cost virtual reality systems that incorporate technology previously not accessible to most therapists and patients. Importantly, they are not confined to rehabilitation departments, can be used at home and provide an accurate record of adherence to exercise. The benefits of providing augmented feedback, increasing intensity of exercise and accurately measuring adherence may improve conventional vestibular rehabilitation but efficacy must first be demonstrated.
Provisional PDF of article here Click here for more information
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.
Click here for more
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.
Click here for more
Wednesday, 25 April 2012
Interactive virtual reality Wii in geriatric day hospital: A study to assess its feasibility, acceptability and efficacy.
Geriatrics & Gerontology International
2012 Apr 2
Chan TC, Chan F, Shea YF, Lin OY, Luk JK, Chan FH. Source Department of Medicine, Division of Geriatrics, Queen Mary Hospital, The University of Hong Kong, Department of Medicine and Geriatrics, Fung Yiu King Hospital, Hong Kong, China
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Abstract
Aim: Rehabilitation using interactive virtual reality Wii (Wii-IVR) was shown to be feasible in patients with different medical problems, but there was no study examining its use in a geriatric day hospital (GDH). The aim of the present study was to test the feasibility, acceptability and efficacy of Wii-IVR in GDH.
Methods: It was a clinical trial with matched historic controls. Patients of a GDH were recruited to participate in Wii-IVR by playing "Wii Fit". Participants used a Wii controller to carry out movements involved in an arm ergometer. Each participant received eight sessions of Wii-IVR in addition to conventional GDH rehabilitation. Feasibility was assessed by the total time receiving Wii-IVR, the percentage of maximal heart rate reserve (%MHR) and Borg perceived exertion scale (BS) after participating in Wii-IVR. %MHR and BS were compared with those after carrying out an arm ergometer for the same duration. Acceptability was assessed by an interviewer-administered questionnaire. Efficacy was assessed by comparing improvements in Functional Independence Measure (FIM) between participants and matched historic controls, who received conventional GDH rehabilitations only.
Results: A total of 30 patients completed the study. Participants completed a total of 1941 min of event-free Wii-IVR. The mean %MHR was 15.9% ± 9.9% and the mean BS was 7.9 ± 2.3. There was no significant difference in %MHR and BS between participating in Wii-IVR and arm ergometer. Most participants found Wii-IVR similar to the arm ergometer, and would like to continue Wii-IVR if they had Wii at home. Improvements in FIM of participants were significantly more than that of historic controls.
Conclusions: Wii-IVR in GDH was feasible and most participants accepted it. Participants had more improvements in FIM.
2012 Apr 2
Chan TC, Chan F, Shea YF, Lin OY, Luk JK, Chan FH. Source Department of Medicine, Division of Geriatrics, Queen Mary Hospital, The University of Hong Kong, Department of Medicine and Geriatrics, Fung Yiu King Hospital, Hong Kong, China
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Abstract
Aim: Rehabilitation using interactive virtual reality Wii (Wii-IVR) was shown to be feasible in patients with different medical problems, but there was no study examining its use in a geriatric day hospital (GDH). The aim of the present study was to test the feasibility, acceptability and efficacy of Wii-IVR in GDH.
Methods: It was a clinical trial with matched historic controls. Patients of a GDH were recruited to participate in Wii-IVR by playing "Wii Fit". Participants used a Wii controller to carry out movements involved in an arm ergometer. Each participant received eight sessions of Wii-IVR in addition to conventional GDH rehabilitation. Feasibility was assessed by the total time receiving Wii-IVR, the percentage of maximal heart rate reserve (%MHR) and Borg perceived exertion scale (BS) after participating in Wii-IVR. %MHR and BS were compared with those after carrying out an arm ergometer for the same duration. Acceptability was assessed by an interviewer-administered questionnaire. Efficacy was assessed by comparing improvements in Functional Independence Measure (FIM) between participants and matched historic controls, who received conventional GDH rehabilitations only.
Results: A total of 30 patients completed the study. Participants completed a total of 1941 min of event-free Wii-IVR. The mean %MHR was 15.9% ± 9.9% and the mean BS was 7.9 ± 2.3. There was no significant difference in %MHR and BS between participating in Wii-IVR and arm ergometer. Most participants found Wii-IVR similar to the arm ergometer, and would like to continue Wii-IVR if they had Wii at home. Improvements in FIM of participants were significantly more than that of historic controls.
Conclusions: Wii-IVR in GDH was feasible and most participants accepted it. Participants had more improvements in FIM.
Saturday, 17 March 2012
Activity-promoting gaming systems in exercise and rehabilitation
Matthew J. D. Taylor, PhD; Darren McCormick, BSc; Teshk Shawis, MBChB, FRCP; Rebecca Impson,
MSc; Murray Griffin, PhD
Journal of Rehabilitation Research & Development
Volume 48, Number 10, 2011 Pages 1171–1186
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Abstract—
Commercial activity-promoting gaming systems provide a potentially attractive means to facilitate exercise and rehabilitation. The Nintendo Wii, Sony EyeToy, Dance Dance Revolution, and Xbox Kinect are examples of gaming systems that use the movement of the player to control gameplay. Activity-promoting gaming systems can be used as a tool to increase activity levels in otherwise sedentary gamers and also be an effective tool to aid rehabilitation in clinical settings. Therefore, the aim of this current work is to review the growing area of activity-promoting gaming in the context of exercise, injury, and rehabilitation.
Key words: activity-promoting, Dance Dance Revolution,
exercise, falls, games, gaming systems, injury, Nintendo Wii,
rehabilitation, Sony EyeToy, Xbox Kinect.
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MSc; Murray Griffin, PhD
Journal of Rehabilitation Research & Development
Volume 48, Number 10, 2011 Pages 1171–1186
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Abstract—
Commercial activity-promoting gaming systems provide a potentially attractive means to facilitate exercise and rehabilitation. The Nintendo Wii, Sony EyeToy, Dance Dance Revolution, and Xbox Kinect are examples of gaming systems that use the movement of the player to control gameplay. Activity-promoting gaming systems can be used as a tool to increase activity levels in otherwise sedentary gamers and also be an effective tool to aid rehabilitation in clinical settings. Therefore, the aim of this current work is to review the growing area of activity-promoting gaming in the context of exercise, injury, and rehabilitation.
Key words: activity-promoting, Dance Dance Revolution,
exercise, falls, games, gaming systems, injury, Nintendo Wii,
rehabilitation, Sony EyeToy, Xbox Kinect.
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Wednesday, 29 February 2012
ReWiiRe: Research for Wii Rehabilitation
Text taken from the ReWiire website
ReWiiRe stands for Research for Wii technology in Rehabilitation. The project aim is twofold. Firstly to investigate therapist use and the patient experience of using the Nintendo Wii console technology in physical rehabilitation programmes in four NHS Trusts across hospital and community settings.
Please click on the link below for comprehensive and detailed information about the project.
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ReWiiRe stands for Research for Wii technology in Rehabilitation. The project aim is twofold. Firstly to investigate therapist use and the patient experience of using the Nintendo Wii console technology in physical rehabilitation programmes in four NHS Trusts across hospital and community settings.
Please click on the link below for comprehensive and detailed information about the project.
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Tuesday, 28 February 2012
Home-based balance training programme using Wii Fit with balance board for Parkinsons’s disease: A pilot study
Journal of Rehabilation Medicine 2012 Feb;44(2):144-50.
Esculier JF, Vaudrin J, Bériault P, Gagnon K, Tremblay LE.
Faculty of Health Sciences, School of Rehabilitation, University of Ottawa, Québec, Canada.
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Esculier JF, Vaudrin J, Bériault P, Gagnon K, Tremblay LE.
Faculty of Health Sciences, School of Rehabilitation, University of Ottawa, Québec, Canada.
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Abstract
Objectives: To evaluate the effects of a home-based balance training programme using visual feedback (Nintendo Wii Fit game with balance board) on balance and functional abilities in subjects with Parkinson’s disease, and to compare the effects with a group of paired healthy subjects.
Subjects: Ten subjects with moderate Parkinson’s disease and 8 healthy elderly subjects.
Methods: Subjects participated in a 6-week home-based balance training programme using Nintendo Wii Fit and balance board. Baseline measures were taken before training for the Sit-to-Stand test (STST), Timed-Up-and-Go (TUG), Tinetti Performance Oriented Mobility Assessment (POMA), 10-m walk test, Community Balance and Mobility assessment (CBM), Activities-specific Balance and Confidence scale (ABC), unipodal stance duration, and a force platform. All measurements were taken again after 3 and 6 weeks of training.
Results: The Parkinson’s disease group significantly improved their results in TUG, STST, unipodal stance, 10-m walk test, CBM, POMA and force platform at the end of the 6-week training programme. The healthy subjects group significantly improved in TUG, STST, unipodal stance and CBM.
Conclusion: This pilot study suggests that a home-based balance programme using Wii Fit with balance board could improve static and dynamic balance, mobility and functional abilities of people affected by Parkinson’s disease.
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Objectives: To evaluate the effects of a home-based balance training programme using visual feedback (Nintendo Wii Fit game with balance board) on balance and functional abilities in subjects with Parkinson’s disease, and to compare the effects with a group of paired healthy subjects.
Subjects: Ten subjects with moderate Parkinson’s disease and 8 healthy elderly subjects.
Methods: Subjects participated in a 6-week home-based balance training programme using Nintendo Wii Fit and balance board. Baseline measures were taken before training for the Sit-to-Stand test (STST), Timed-Up-and-Go (TUG), Tinetti Performance Oriented Mobility Assessment (POMA), 10-m walk test, Community Balance and Mobility assessment (CBM), Activities-specific Balance and Confidence scale (ABC), unipodal stance duration, and a force platform. All measurements were taken again after 3 and 6 weeks of training.
Results: The Parkinson’s disease group significantly improved their results in TUG, STST, unipodal stance, 10-m walk test, CBM, POMA and force platform at the end of the 6-week training programme. The healthy subjects group significantly improved in TUG, STST, unipodal stance and CBM.
Conclusion: This pilot study suggests that a home-based balance programme using Wii Fit with balance board could improve static and dynamic balance, mobility and functional abilities of people affected by Parkinson’s disease.
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Sunday, 26 February 2012
Using the Nintendo Wii as an Intervention in a Falls Prevention Group
Journal of American Geriatrics Society. 2012 Feb;60(2):385-7
Griffin M, Shawis T, Impson R, McCormick D, Taylor MJ.
Department of Biological Sciences, University of Essex.
No abstract is available for this article.
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Griffin M, Shawis T, Impson R, McCormick D, Taylor MJ.
Department of Biological Sciences, University of Essex.
No abstract is available for this article.
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Saturday, 25 February 2012
Stroke patients' experiences with Wii Sports® during inpatient rehabilitation
Scandinavian Journal of Occupational Therapy
Posted online on February 20, 2012
Authors: Dora Celinder & Hanne Peoples
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Abstract
Posted online on February 20, 2012
Authors: Dora Celinder & Hanne Peoples
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Abstract
Introduction: Commercial virtual reality games have been used as adjunct therapy for stroke rehabilitation, mainly after patients have been discharged. The aim of this study was to explore stroke patients' experiences with Wii Sports® as a supplement to conventional occupational therapy in a controlled hospital setting.
Materials and methods: The study had a qualitative triangulation design that included semi-structured interviews and field notes. Nine Danish stroke patients participated, receiving between one and nine interventions with Wii Sports® during a three-week period. Responses were coded by qualitative content analysis.
Results: Analysis revealed one overarching category, “Connecting to past, present, and future occupations”, and three categories that encompassed patients' experiences with Wii: (i) variety, (ii) engagement, and (iii) obstacles and challenges. Interview findings were confirmed by field notes that included observations of engagement and challenges.
Discussion: Stroke patients in hospital settings may experience Wii Sports® as a beneficial and challenging occupation for both rehabilitation and leisure. Incorporation of Wii Sports® into conventional occupational therapy services may benefit patient rehabilitation directly or provide motivation for alternative leisure activities.
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Tuesday, 20 December 2011
A Pilot Study of Wii Fit Exergames to Improve Balance in Older Adults
Journal of Geriatric Physical Therapy:
October/December 2011 - Volume 34 - Issue 4 - p 161–167
Agmon, Maayan PT, PhD, MA, BA; Perry, Cynthia K. PhD, ARNP; Phelan, Elizabeth MD, MS; Demiris, George PhD; Nguyen, Huong Q. PhD
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Abstract
Purpose: To determine the safety and feasibility of using Nintendo Wii Fit exergames to improve balance in older adults.
Methods: Seven older adults aged 84 (5) years with impaired balance (Berg Balance Scale [BBS] score < 52 points) were recruited from 4 continuing care retirement communities to participate in a single group pre- and postevaluation of Wii Fit exergames. Participants received individualized instructions (at least 5 home visits) on playing 4 exergames (basic step, soccer heading, ski slalom, and table tilt) and were asked to play these games in their homes at least 30 minutes 3 times per week for 3 months and received weekly telephone follow-up. They also completed a paper log of their exergame play and rated their enjoyment immediately after each session. Participants completed the BBS, 4-Meter Timed Walk test, and the Physical Activity Enjoyment Scale at baseline and 3 months. Semistructured interviews were conducted at the 3-month evaluation.
Results: Participants safely and independently played a mean of 50 sessions, median session duration of 31 minutes. Two of the games were modified to ensure participants' safety. Participants rated high enjoyment immediately after exergame play and expressed experiencing improved balance with daily activities and desire to play exergames with their grandchildren. Berg Balance Scores increased from 49 (2.1) to 53 (1.8) points (P = .017). Walking speed increased from 1.04 (0.2) to 1.33 (0.84) m/s (P = .018).
Conclusions: Use of Wii Fit for limited supervised balance training in the home was safe and feasible for a selected sample of older adults. Further research is needed to determine clinical efficacy in a larger, diverse sample and ascertain whether Wii Fit exergames can be integrated into physical therapy practice to promote health in older adults.
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October/December 2011 - Volume 34 - Issue 4 - p 161–167
Agmon, Maayan PT, PhD, MA, BA; Perry, Cynthia K. PhD, ARNP; Phelan, Elizabeth MD, MS; Demiris, George PhD; Nguyen, Huong Q. PhD
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Abstract
Purpose: To determine the safety and feasibility of using Nintendo Wii Fit exergames to improve balance in older adults.
Methods: Seven older adults aged 84 (5) years with impaired balance (Berg Balance Scale [BBS] score < 52 points) were recruited from 4 continuing care retirement communities to participate in a single group pre- and postevaluation of Wii Fit exergames. Participants received individualized instructions (at least 5 home visits) on playing 4 exergames (basic step, soccer heading, ski slalom, and table tilt) and were asked to play these games in their homes at least 30 minutes 3 times per week for 3 months and received weekly telephone follow-up. They also completed a paper log of their exergame play and rated their enjoyment immediately after each session. Participants completed the BBS, 4-Meter Timed Walk test, and the Physical Activity Enjoyment Scale at baseline and 3 months. Semistructured interviews were conducted at the 3-month evaluation.
Results: Participants safely and independently played a mean of 50 sessions, median session duration of 31 minutes. Two of the games were modified to ensure participants' safety. Participants rated high enjoyment immediately after exergame play and expressed experiencing improved balance with daily activities and desire to play exergames with their grandchildren. Berg Balance Scores increased from 49 (2.1) to 53 (1.8) points (P = .017). Walking speed increased from 1.04 (0.2) to 1.33 (0.84) m/s (P = .018).
Conclusions: Use of Wii Fit for limited supervised balance training in the home was safe and feasible for a selected sample of older adults. Further research is needed to determine clinical efficacy in a larger, diverse sample and ascertain whether Wii Fit exergames can be integrated into physical therapy practice to promote health in older adults.
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Wednesday, 2 November 2011
Feasibility and observed safety of interactive video games for physical rehabilitation in the intensive care unit: a case series
Journal of Critical Care
Available online 25 September 2011.
Michelle E. Kho PT, PhD, Abdulla Damluji MBChB, MPH , Jennifer M. Zanni PT, MSPT, ScD, Dale M. Needham MD, PhDa
Available online 25 September 2011.
Michelle E. Kho PT, PhD, Abdulla Damluji MBChB, MPH , Jennifer M. Zanni PT, MSPT, ScD, Dale M. Needham MD, PhDa
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Abstract
Background
Early rehabilitation in the intensive care unit (ICU) improves patients' physical function. Despite reports of using commercially available interactive video game systems for rehabilitation, there are few data evaluating feasibility and safety as part of routine in-patient rehabilitation, particularly in the ICU.
Methods
We conducted an observational study from September 1, 2009, to August 31, 2010, of adults admitted to a 16-bed medical ICU receiving video games as part of routine physical therapy (PT), evaluating use and indications and occurrence of 14 prospectively monitored safety events.
Results
Of 410 patients receiving PT in the medical ICU, 22 (5% of all patients; male, 64%; median age, 52 years) had 42 PT treatments with video games (median [interquartile range] per patient, 1.0 [1.0-2.0]). Main indications for video game therapy included balance (52%) and endurance (45%), and the most common activities included boxing (38%), bowling (24%), and balance board (21%). Of 42 treatments, 69% occurred while standing and 45% while mechanically ventilated. During 35 hours of PT treatment, 0 safety events occurred (95% upper confidence limit for safety event rate, 8.4%).
Conclusions
Novel use of interactive video games as part of routine PT in critically ill patients is feasible and appears safe in our case series. Video game therapy may complement existing rehabilitation techniques for ICU patients.
Keywords: Rehabilitation; Critical care; Adults; Mechanical ventilation; Interactive video games Click here for more
Abstract
Background
Early rehabilitation in the intensive care unit (ICU) improves patients' physical function. Despite reports of using commercially available interactive video game systems for rehabilitation, there are few data evaluating feasibility and safety as part of routine in-patient rehabilitation, particularly in the ICU.
Methods
We conducted an observational study from September 1, 2009, to August 31, 2010, of adults admitted to a 16-bed medical ICU receiving video games as part of routine physical therapy (PT), evaluating use and indications and occurrence of 14 prospectively monitored safety events.
Results
Of 410 patients receiving PT in the medical ICU, 22 (5% of all patients; male, 64%; median age, 52 years) had 42 PT treatments with video games (median [interquartile range] per patient, 1.0 [1.0-2.0]). Main indications for video game therapy included balance (52%) and endurance (45%), and the most common activities included boxing (38%), bowling (24%), and balance board (21%). Of 42 treatments, 69% occurred while standing and 45% while mechanically ventilated. During 35 hours of PT treatment, 0 safety events occurred (95% upper confidence limit for safety event rate, 8.4%).
Conclusions
Novel use of interactive video games as part of routine PT in critically ill patients is feasible and appears safe in our case series. Video game therapy may complement existing rehabilitation techniques for ICU patients.
Keywords: Rehabilitation; Critical care; Adults; Mechanical ventilation; Interactive video games Click here for more
Monday, 31 October 2011
Use of Nintendo(R) Wii(TM) During Postburn Rehabilitation: A Pilot Study
Journal of Burn Care & Research:
POST COPYEDIT, 5 October 2011
2011 Clinical Research Award: PDF Only
Yohannan, Sam K. PT, MS; Tufaro, Patricia OTR/L; Hunter, Hope PT; Orleman, Lauren SPT; Palmatier, Sara SPT; Sang, Canace SPT; Gorga, Delia I. PhD, OTR/L; Yurt, Roger W. MD, FACS
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POST COPYEDIT, 5 October 2011
2011 Clinical Research Award: PDF Only
Yohannan, Sam K. PT, MS; Tufaro, Patricia OTR/L; Hunter, Hope PT; Orleman, Lauren SPT; Palmatier, Sara SPT; Sang, Canace SPT; Gorga, Delia I. PhD, OTR/L; Yurt, Roger W. MD, FACS
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Abstract
The purpose of this study was to demonstrate feasibility and measure outcomes on pain, anxiety, active range of motion (AROM), function, enjoyment, and presence (immersion into a virtual environment) with the adjunctive use of Nintendo(R) Wii(TM) (Nintendo of America Inc., Redmond, WA) during acute postburn rehabilitation. Participants were alternated and stratified based on the location of burn into Wii or control treatment groups. Joints of interest with limited AROM were the shoulder, elbow, wrist, hip, knee, and ankle. All participants received three consecutive sessions of passive range of motion and predetermined joint-specific exercises. This was followed by either designated Wii games or therapist-chosen interventions (control). The outcomes were compared between groups using t-tests (P < .05) and Cohen's d statistic. Data from 23 participants aged 20 to 78 years were analyzed. The difference in mean slopes suggested that the Wii group experienced less pain (x = -0.97, P = .07) than the control group over time. Overall, trends with anxiety (x = -0.11, P = .77), AROM (x = 0.55, P = .81), function (x = -0.38, P = .43), and enjoyment (x = 0.09, P = .73) seemed to improve at a faster rate in the Wii group. Presence minimally changed between successive treatment sessions for those in the Wii group. Although statistical significance was not reached in any category, feasibility was supported, and the overall pattern for outcomes was positive for the Wii group, the most favorable being for pain reduction. Future research with larger sample sizes is warranted to explore best practice with video game technology throughout the continuum of burn rehabilitation with appropriate prescriptions.
(C) 2011 The American Burn Association
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The purpose of this study was to demonstrate feasibility and measure outcomes on pain, anxiety, active range of motion (AROM), function, enjoyment, and presence (immersion into a virtual environment) with the adjunctive use of Nintendo(R) Wii(TM) (Nintendo of America Inc., Redmond, WA) during acute postburn rehabilitation. Participants were alternated and stratified based on the location of burn into Wii or control treatment groups. Joints of interest with limited AROM were the shoulder, elbow, wrist, hip, knee, and ankle. All participants received three consecutive sessions of passive range of motion and predetermined joint-specific exercises. This was followed by either designated Wii games or therapist-chosen interventions (control). The outcomes were compared between groups using t-tests (P < .05) and Cohen's d statistic. Data from 23 participants aged 20 to 78 years were analyzed. The difference in mean slopes suggested that the Wii group experienced less pain (x = -0.97, P = .07) than the control group over time. Overall, trends with anxiety (x = -0.11, P = .77), AROM (x = 0.55, P = .81), function (x = -0.38, P = .43), and enjoyment (x = 0.09, P = .73) seemed to improve at a faster rate in the Wii group. Presence minimally changed between successive treatment sessions for those in the Wii group. Although statistical significance was not reached in any category, feasibility was supported, and the overall pattern for outcomes was positive for the Wii group, the most favorable being for pain reduction. Future research with larger sample sizes is warranted to explore best practice with video game technology throughout the continuum of burn rehabilitation with appropriate prescriptions.
(C) 2011 The American Burn Association
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Abstract
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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