Tuesday 20 September 2011

METs in Adults While Playing Active Video Games: A Metabolic Chamber Study

Medicine & Science in Sports & Exercise: June 2010 - Volume 42 - Issue 6 - pp 1149-1153 MIYACHI, MOTOHIKO; YAMAMOTO, KENTA; OHKAWARA, KAZUNORI; TANAKA, SHIGEHO +/- Click for more/less
Abstract Purpose: Active video game systems controlled through arm gestures and motions (Nintendo Wii Sports) and video games controlled through force plate (Wii Fit Plus) are becoming increasingly popular. This study was performed to determine the energy expenditure (EE) during Wii Fit Plus and Wii Sports game activities. Methods: Twelve adult men and women performed all the activities of Wii Sports (five activities: golf, bowling, tennis, baseball, and boxing) and Wii Fit Plus (63 activities classified as yoga, resistance, balance, and aerobic exercises). Each activity was continued for at least 8 min to obtain a steady-state EE. Because EE was assessed in an open-circuit indirect metabolic chamber consisting of an airtight room (20,000 or 15,000 L), subjects were freed of apparatus to collect expired gas while playing the games. MET value was calculated from resting EE and steady-state EE during activity. Results: The mean MET values of all 68 activities were distributed over a wide range from 1.3 METs (Lotus Focus) to 5.6 METs (single-arm stand). The mean MET values in yoga, balance, resistance, and aerobic exercise of Wii Fit Plus and Wii Sports were 2.1, 2.0, 3.2, 3.4, and 3.0 METs, respectively. Forty-six activities (67%) were classified as light intensity (<3 METs), and 22 activities (33%) were classified as moderate intensity (3.0-6.0 METs). There were no vigorous-intensity activities (>6.0 METs). Conclusions: Time spent playing one-third of the activities supplied by motion- and gesture-controlled video games can count toward the daily amount of exercise required according to the guidelines provided by the American College of Sports Medicine and the American Heart Association, which focus on 30 min of moderate-intensity daily physical activity 5 d·wk−1. Click for more details

Wednesday 14 September 2011

Incorporating Gaming Technology into Athletic Injury Rehabilitation

Athletic Training & Sports Health Care March/April 2009 - Volume 1 · Issue 2: 79-84

David A. Middlemas, EdD, ATC; Jeffrey Basilicato, ATC; Michael Prybicien, MA, ATC; Joseph Savoia, MS, ATC; Jenna Biodoglio

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ABSTRACT
Rehabilitation of athletes presents challenges relating to proprioceptive training, reacquisition of sport-related skills, and maintaining the patient’s interest. Incorporation of video gaming technology into the rehabilitation process has been reported in physical therapy, stroke rehabilitation, geriatric exercise, and physical education. Reported feedback indicates that the technology is well received by patients. The purpose of this article is to present video gaming technology, such as the Nintendo Wii, as an alternative tool for clinicians to use in rehabilitation. We present examples of the use of video game activities from the Wii Sports software package in injury rehabilitation. The sport activities selected require patients to simulate athletic motions and skills while competing in the selected activity. In addition, examples of use of gaming activities with traditional balance and proprioceptive equipment are presented.

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Virtual reality for stroke rehabilitation: Review

Cochrane Database Syst Rev. 2011 Sep 7;9.
Laver KE, George S, Thomas S, Deutsch JE, Crotty M.
Department of Rehabilitation and Aged Care, Flinders University, Repatriation General Hospitals, Daws Road, Daw Park, Adelaide, Australia, 5041.
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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).

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Tuesday 13 September 2011

Making Things Possible: Technology plays a role in neurorehabilitation for stroke patients.

Rehab Management: The Interdisciplinary Journal of Rehabilitation Nov/Dec2010, Vol. 23 Issue 10, p10 3p.

By Sue Golden, PT, and Kathryn Sleazak, PT, MSc

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Abstract:
The article focuses on the applicability of innovative technologies in rehabilitating patients who have suffered from stroke. It highlights the technologies that can be applied in neurorehabilitation including e-stim foot drop device, computerized balance training and assessment equipment, and Tibion bionic leg robotic device. Furthermore, the technologies' benefits to several stroke patients are also mentioned.

Monday 12 September 2011

A Kinect-based system for physical rehabilitation: A pilot study for young adults with motor disabilities.

Research in Developmental Disabilities. 2011 Jul 22. Chang YJ, Chen SF, Huang JD. Department of Electronic Engineering, Chung Yuan Christian University, Chung-Li, Taiwan
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Abstract This study assessed the possibility of rehabilitating two young adults with motor impairments using a Kinect-based system in a public school setting. This study was carried out according to an ABAB sequence in which A represented the baseline and B represented intervention phases. Data showed that the two participants significantly increased their motivation for physical rehabilitation, thus improving exercise performance during the intervention phases. Practical and developmental implications of the findings are discussed. Highlights ► To reduce staff intervention and enhance students’ motivation, interest, and perseverance to engage in physical rehabilitation, a Kinect-based system was employed with success. ► Single subject research design was used with two young adults who were diagnosed with motor disability. ► Data showed that the participants improve exercise performance during the intervention phases. Click here for more

Sunday 11 September 2011

The effects of single bouts of aerobic exercise, exergaming, and videogame play on cognitive control.

Clinical Neurophysiology. 2011 Aug;122(8):1518-25. Kevin C. O’Leary, Matthew B. Pontifex, Mark R. Scudder, Michael L. Brown, Charles H. Hillman Department of Kinesiology & Community Health, 317 Louise Freer Hall, 906 South Goodwin Avenue, University of Illinois, Urbana, IL 61801, USA

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Abstract Objective The effects of single bouts of aerobic exercise, exergaming, and action videogame play on event-related brain potentials (ERPs) and task performance indices of cognitive control were investigated using a modified flanker task that manipulated demands of attentional inhibition. Methods Participants completed four counterbalanced sessions of 20min of activity intervention (i.e., seated rest, seated videogame play, and treadmill-based and exergame-based aerobic exercise at 60% HRmax) followed by cognitive testing once heart rate (HR) returned to within 10% of pre-activity levels. Results Results indicated decreased RT interference following treadmill exercise relative to seated rest and videogame play. P3 amplitude was increased following treadmill exercise relative to rest, suggesting an increased allocation of attentional resources during stimulus engagement. The seated videogame and exergame conditions did not differ from any other condition. Conclusions The findings indicate that single bouts of treadmill exercise may improve cognitive control through an increase in the allocation of attentional resources and greater interference control during cognitively demanding tasks. However, similar benefits may not be derived following short bouts of aerobic exergaming or seated videogame participation. Significance Although exergames may increase physical activity participation, they may not exert the same benefits to brain and cognition as more traditional physical activity behaviors. Click here for more

Did too much Wii cause your patient’s injury?

The Journal of Family Practice - July 2011 · Vol. 60, No. 07: 404-409

Dorothy A. Sparks, MD, Lisa M. Coughlin, MD, Daniel M. Chase, MD

Motion-controlled game consoles like Wii may be used to play virtual sports, but the injuries associated with them are real. Here’s what to watch for—and a handy table linking specific games to particular injuries.

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Abstract
Motion-controlled game consoles like Wii may be used to play virtual sports, but the injuries associated with them are real. Here's what to watch for--and a handy table linking specific games to particular injuries.

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Monday 5 September 2011

Feasibility and Benefit of Using the Nintendo Wii Fit for Balance Rehabilitation in an Elderly Patient Experiencing Recurrent Falls

JOURNAL OF STUDENT PHYSICAL THERAPY RESEARCH | 2010 VOLUME 2, NUMBER 1, ARTICLE 2

Tony Pigford, DPT
Director of Outpatient Physical Therapy, Duplin General Hospital – Kenansville, NC
A. Williams Andrews, PT, EdD, NCS
Associate Professor, Department of Physical Therapy Education, Elon University – Elon, N


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ABSTRACT
Introduction: The purpose of this case report was to examine whether a balance training program utilizing the
Nintendo Wii Fit platform could improve dynamic balance control in an elderly patient with balance impairments.
Also, the investigators sought to determine whether the motivational aspect of the video games would stimulate the
patient’s desire to participate in the balance rehabilitation program. Case Description: An elderly patient with a
recent history of falls underwent two weeks of balance training utilizing the Wii Fit platform along with other
traditional therapeutic interventions. Pre-intervention and post-intervention outcome measures were recorded. For
this report, the selected outcome measures were: Berg Balance Scale, Activities-specific Balance Confidence Scale,
Timed Up and Go, and gait speed. Outcomes: Post-intervention, the patient demonstrated improvements in all of
the selected balance outcome measures. During the intervention, the patient demonstrated a high level of
cooperation resulting in increased time spent performing balance activities. Conclusions: This case report gives
insight on how the Wii Fit was combined with more traditional physical therapy interventions to enhance an elderly
patient’s participation in the interventions and improve balance performance.

Thursday 1 September 2011

On the use of the Wii Fit™ in reducing falling risk factors and improving balance for the elderly

Kinesitherapie Revue (KINESITHERAPIE REVUE), 2010 Nov(107): 41-5 (13 ref)

Grosjean, Aurélie ; Fabbri, Emmeline ; Feldheim, Eric ; Snoeck, Thyl ; Amand, Marc ; Keuterickx, Claude ; Balestra, Costantino

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Abstract
Background: The Nintendo® game console, called Wii Fit[TM], distinguishes itself from the other game consoles. In fact, it has many exercises that engage all body parts. We undertook this study to evaluate the usefulness of this type of game console by means of its included programs provided to improve balance and risk of falls among the elderly.

Method: The main evaluation tools that we used are specific tests for balance and walking, and the Nintendo® Wii Fit[TM] console. This study is based on a sample population of 21 people aged over 65 years (mean age: 85,67 ± 6,14 years) and divided into a control group and experimental group.

Results: Our results show a highly significant improvement between the control and experimental group after six weeks of training on the game console.

Level of evidence: 4 (Not randomized comparative study)

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