Published online before print - 28 July 2011
Physical Therapy October 2011 vol. 91 no. 10 1449-1462
Tony Szturm, Aimee L. Betker, Zahra Moussavi, Ankur Desai andValerie Goodman
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Saturday 12 November 2011
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
Tuesday 1 November 2011
Energy Expenditure and Enjoyment during Video Game Play: Differences by Game Type
Medicine & Science in Sports & Exercise:
October 2011 - Volume 43 - Issue 10 - pp 1987-1993
LYONS, ELIZABETH J.; TATE, DEBORAH F., WARD, DIANNE S.; BOWLING, J. MICHAEL; RIBISL, KURT M.; KALYARARAMAN, SRIRAM
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Abstract
Purpose: Play of physically active video games may be a way to increase physical activity and/or decrease sedentary behavior, but games are not universally active or enjoyable. Active games may differ from traditional games on important attributes, which may affect frequency and intensity of play. The purpose of this study was to investigate differences in energy expenditure and enjoyment across four game types: shooter (played with traditional controllers), band simulation (guitar or drum controller), dance simulation (dance mat controller), and fitness (balance board controller).
Methods: Energy expenditure (METs) and enjoyment were measured across 10 games in 100 young adults age 18-35 yr (50 women).
Results: All games except shooter games significantly increased energy expenditure over rest (P < 0.001). Fitness and dance games increased energy expenditure by 322% (mean ± SD = 3.10 ± 0.89 METs) and 298% (2.91 ± 0.87 METs), which was greater than that produced by band simulation (73%, 1.28 ± 0.28 METs) and shooter games (23%, 0.91 ± 0.16 METs). However, enjoyment was higher in band simulation games than in other types (P < 0.001). Body mass-corrected energy expenditure was greater in normal weight than in overweight participants in the two most active game types (P < 0.001).
Conclusions: Active video games can significantly increase energy expended during screen time, but these games are less enjoyable than other more sedentary games, suggesting that they may be less likely to be played over time. Less active but more enjoyable video games may be a promising method for decreasing sedentary behavior.
©2011The American College of Sports Medicine
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October 2011 - Volume 43 - Issue 10 - pp 1987-1993
LYONS, ELIZABETH J.; TATE, DEBORAH F., WARD, DIANNE S.; BOWLING, J. MICHAEL; RIBISL, KURT M.; KALYARARAMAN, SRIRAM
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Abstract
Purpose: Play of physically active video games may be a way to increase physical activity and/or decrease sedentary behavior, but games are not universally active or enjoyable. Active games may differ from traditional games on important attributes, which may affect frequency and intensity of play. The purpose of this study was to investigate differences in energy expenditure and enjoyment across four game types: shooter (played with traditional controllers), band simulation (guitar or drum controller), dance simulation (dance mat controller), and fitness (balance board controller).
Methods: Energy expenditure (METs) and enjoyment were measured across 10 games in 100 young adults age 18-35 yr (50 women).
Results: All games except shooter games significantly increased energy expenditure over rest (P < 0.001). Fitness and dance games increased energy expenditure by 322% (mean ± SD = 3.10 ± 0.89 METs) and 298% (2.91 ± 0.87 METs), which was greater than that produced by band simulation (73%, 1.28 ± 0.28 METs) and shooter games (23%, 0.91 ± 0.16 METs). However, enjoyment was higher in band simulation games than in other types (P < 0.001). Body mass-corrected energy expenditure was greater in normal weight than in overweight participants in the two most active game types (P < 0.001).
Conclusions: Active video games can significantly increase energy expended during screen time, but these games are less enjoyable than other more sedentary games, suggesting that they may be less likely to be played over time. Less active but more enjoyable video games may be a promising method for decreasing sedentary behavior.
©2011The American College of Sports Medicine
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Background Due to the many problems associated with reduced balance and mobility, providing an effective and engaging rehabilitation regimen is essential to progress recovery from impairments and to help prevent further degradation of motor skills.
Objectives The purpose of this study was to examine the feasibility and benefits of physical therapy based on a task-oriented approach delivered via an engaging, interactive video game paradigm. The intervention focused on performing targeted dynamic tasks, which included reactive balance controls and environmental interaction.
Design This study was a randomized controlled trial.
Setting The study was conducted in a geriatric day hospital.
Participants Thirty community-dwelling and ambulatory older adults attending the day hospital for treatment of balance and mobility limitations participated in the study.
Interventions Participants were randomly assigned to either a control group or an experimental group. The control group received the typical rehabilitation program consisting of strengthening and balance exercises provided at the day hospital. The experimental group received a program of dynamic balance exercises coupled with video game play, using a center-of-pressure position signal as the computer mouse. The tasks were performed while standing on a fixed floor surface, with progression to a compliant sponge pad. Each group received 16 sessions, scheduled 2 per week, with each session lasting 45 minutes. Measurements Data for the following measures were obtained before and after treatment: Berg Balance Scale, Timed “Up & Go” Test, Activities-specific Balance Confidence Scale, modified Clinical Test of Sensory Interaction and Balance, and spatiotemporal gait variables assessed in an instrumented carpet system test.
Results Findings demonstrated significant improvements in posttreatment balance performance scores for both groups, and change scores were significantly greater in the experimental group compared with the control group. No significant treatment effect was observed in either group for the Timed “Up & Go” Test or spatiotemporal gait variables.
Limitations The sample size was small, and there were group differences at baseline in some performance measures. Conclusion Dynamic balance exercises on fixed and compliant sponge surfaces were feasibly coupled to interactive game-based exercise. This coupling, in turn, resulted in a greater improvement in dynamic standing balance control compared with the typical exercise program. However, there was no transfer of effect to gait function.
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