Posts Tagged Nintendo Wii

[Abstract] Virtual Rehabilitation through Nintendo Wii in Poststroke Patients: Follow-Up

Objective

To evaluate in the follow-up the sensory-motor recovery and quality of life patients 2 months after completion of the Nintendo Wii console intervention and determine whether learning retention was obtained through the technique.

Methods

Five hemiplegics patients participated in the study, of whom 3 were male with an average age of 54.8 years (SD = 4.6). Everyone practiced Nintendo Wii therapy for 2 months (50 minutes/day, 2 times/week, during 16 sessions). Each session lasting 60 minutes, under a protocol in which only the games played were changed, plus 10 minutes of stretching. In the first session, tennis and hula hoop games were used; in the second session, football (soccer) and boxing were used. For the evaluation, the Fulg-Meyer and Short Form Health Survey 36 (SF-36) scales were utilized. The patients were immediately evaluated upon the conclusion of the intervention and 2 months after the second evaluation (follow-up).

Results

Values for the upper limb motor function sub-items and total score in the Fugl–Meyer scale evaluation and functional capacity in the SF-36 questionnaire were sustained, indicating a possible maintenance of the therapeutic effects.

Conclusion

The results suggest that after Nintendo Wii therapy, patients had motor learning retention, achieving a sustained benefit through the technique.

via Virtual Rehabilitation through Nintendo Wii in Poststroke Patients: Follow-Up

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[WEB SITE] TherapWii – game suggestions

Why TherapWii

Gaming activates and is fun to do! In a playful and often unnoticed way skills are trained. Adolescents grow up in a digital world; they enjoy gaming and do it frequently. For adults and elderly gaming has been shown to be a useful type of therapy.

In a virtual environment moving, executing, learning and enjoying are appealing; if circumstances or limitations keep you from going to the bowling alley or playing an instrument, gaming can broaden your boundaries.

Gaming with the Wii can complement therapy, can make therapy more attractive, intenser and more provocative.

TherapWii has been developed to support therapists in an effective and specific way while using the Nintendo Wii and offer options to game in the home environment.

TherapWii is the product of an exploratory research project done by the Special Lectorship Rehabilitation at the Hague University. The results of this project can be found by clicking on the header ‘research’ at the end of the page.

How does TherapWii work?

Per therapy goal there are three colored tabs to help find the most suitable games. Each game lists specific information in text and symbols. There is also a level of difficulty; by moving the cursor over this button you see more information.

User information is saved in ‘explanation and tips’. To enhance this section you can email recommendations and suggestions to the email address listed below.

TherapWii has been developed, also for home use, so that experience lead to personal growth.

Advice for game adjustments

It is important that the therapist stays close to the patient’s goals and abilities and adjusts the game program appropriately. If you, as therapist, want to make the game easier, more difficult or more daring, you can change the instruction, implementation or setting.

A few examples:

Physical: strength (add weights to the arms or legs or change the starting position); balance/stability (play while standing on an instable foundation (ball, mat). Or play the games while sitting on a stationary bicycle!

Cognition: create double tasks (ask mathematics, questions or riddles); spatial orientation or visual adjustments (play with one eye covered or in front of a mirror).

Social-emotional: stimulate cooperation or competition (create bets or role-playing).

Let us know if you have other ideas to make the games more provoking.

How are the games rated?

The games were tested by several professionals (physical therapists, occupational therapists and sport therapists). Differences in opinion or scores were discussed and voted on.

Give us feedback, corrections and advice, we will adjust the TherapWii program monthly and will use your suggestions.

Which ability do you choose?

Social-Emotional

Physical

Cognitive

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[WEB SITE] Reh@Panel (formerly RehabNet CP) – NeuroRehabLab Tools

 

Reh@Panel (formerly RehabNet CP) acts as a device router, bridging a large number of tracking devices and other hardware with the RehabNet Training Games for the patient to interact with. Reh@Panel implements the communication protocols in a client/server architecture. Native device support for:

Electrophysiological Data

 

  • Emotiv EPOC neuro-headset is intergrated for acquiring raw EEG data, gyroscope data, facial expressions and Emotiv’s Expressiv™, Cognitiv™ and Affectiv™ suite
  • Neurosky EEG headset is supported for raw EEG acquisition and eSense™ meters of attention and meditation
  • Myoelectric orthosis mPower 1000 (Myomo Inc, Boston, USA) is supported, providing 2 EMG channels and adjustable levels of assistance

 

more —> Reh@Panel (formerly RehabNet CP) | NeuroRehabLab Tools

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[WEB SITE] Activities like playing cards may assist stroke rehab as well as virtual reality – Medical News Today

Published: Tuesday 28 June 2016

Results could inform 15 million people who suffer stroke each year.

Sometimes in health care, simple activities can be just as effective as the latest technology.

A new study has found that simple, widely available and inexpensive activities such as playing cards or repeatedly throwing a foam ball or wad of paper into a wastepaper basket are just as effective in helping people regain strength and co-ordination following a stroke as playing virtual reality games.

The study, published in the journal Lancet Neurology, is encouraging news for the 15 million people worldwide who suffer a stroke each year and may not live near a stroke rehabilitation centre or in a country with a sophisticated health-care system, or have health-care insurance, said lead author Dr. Gustavo Saposnik, a neurologist at St. Michael’s Hospital in Toronto.

The study was based on a clinical trial conducted at 14 centres in four countries in which patients were randomized into two groups. In addition to conventional rehabilitation therapy, one group received 10, one-hour sessions of virtual reality using the Nintendo Wii system and the other spent the same amount of time doing simple recreational activities such as playing cards or dominoes.

Patients randomized to both groups saw a 30 per cent and 40 per cent improvement in motor performance at the end of two weeks of the intervention and four weeks after the intervention, respectively.

“But there was no significant difference between the two groups in terms of strength, dexterity, gross motor skills, quality of life or activities of daily living,” said Dr. Saposnik, who is also a scientist in St. Michael’s Li Ka Shing Knowledge Institute. “We all like technology and have the tendency to think that new technology is better than old-fashioned strategies, but sometimes that’s not the case. In this study, we found that simple recreational activities that can be implemented anywhere may be as effective as technology.”

Dr. Saposnik said he was surprised by the results, because many previous studies, including his own, had a different conclusion, and because virtual reality has become an emerging strategy to enhance motor skills in stroke rehabilitation. Previous studies and review, including Dr. Saposnik’s pilot study published in 2010, suggested up to 20 to 30 per cent improvements in the motor skills of patients who had virtual reality therapy.

Dr. Saposnik said the new findings could be the result of the fact this clinical trial was the largest of its kind and used a more accurate comparison of the total time of therapy each group had. Both groups of randomized patients received the same amount of conventional therapy and then the same amount of time of either recreational activities or virtual reality. In previous studies, groups who received conventional and virtual reality therapy were compared to those who received only conventional therapy, with no add-ons.

This study received funding from the Heart and Stroke Foundation of Canada, the Ontario Stroke Strategy and the Ontario Ministry of Health and Long-Term Care.

Article: Efficacy and safety of non-immersive virtual reality exercising in stroke rehabilitation (EVREST): a randomised, multicentre, single-blind, controlled trial, Dr Gustavo Saposnik, MDcorrespondenceemail, Leonardo G Cohen, MD, Muhammad Mamdani, PharmD, Sepideth Pooyania, MD, Michelle Ploughman, PhD, Donna Cheung, OT, Jennifer Shaw, RhT, Judith Hall, MSc, Peter Nord, MD, Sean Dukelow, MD, Yongchai Nilanont, MD, Felipe De los Rios, MD, Lisandro Olmos, MD, Mindy Levin, PhD, Robert Teasell, MD, Ashley Cohen, MSc, Prof Kevin Thorpe, MMath, Prof Andreas Laupacis, MD, Mark Bayley, MD for Stroke Outcomes Research, Lancet Neurology, doi: 10.1016/S1474-4422(16)30121-1, published online 27 June 2016.

Source: Activities like playing cards may assist stroke rehab as well as virtual reality – Medical News Today

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[Abstract] Virtual reality gaming in the rehabilitation of the upper extremities post-stroke. 

Abstract

Background: Occurrences of strokes often result in unilateral upper limb dysfunction. Dysfunctions of this nature frequently persist and can present chronic limitations to activities of daily living.
Methods: Research into applying virtual reality gaming systems to provide rehabilitation therapy have seen resurgence. Themes explored in stroke rehab for paretic limbs are action observation and imitation, versatility, intensity and repetition and preservation of gains. Fifteen articles were ultimately selected for review. The purpose of this literature review is to compare the various virtual reality gaming modalities in the current literature and ascertain their efficacy.
Results: The literature supports the use of virtual reality gaming rehab therapy as equivalent to traditional therapies or as successful augmentation to those therapies. While some degree of rigor was displayed in the literature, small sample sizes, variation in study lengths and therapy durations and unequal controls reduce generalizability and comparability.
Conclusions: Future studies should incorporate larger sample sizes and post-intervention follow-up measures.

Source: Virtual reality gaming in the rehabilitation of the upper extremities post-stroke – Brain Injury | Taylor & Francis Online

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[Abstract] Virtual reality gaming in the rehabilitation of the upper extremities post-stroke.

Abstract

Background: Occurrences of strokes often result in unilateral upper limb dysfunction. Dysfunctions of this nature frequently persist and can present chronic limitations to activities of daily living.
Methods: Research into applying virtual reality gaming systems to provide rehabilitation therapy have seen resurgence. Themes explored in stroke rehab for paretic limbs are action observation and imitation, versatility, intensity and repetition and preservation of gains. Fifteen articles were ultimately selected for review. The purpose of this literature review is to compare the various virtual reality gaming modalities in the current literature and ascertain their efficacy.
Results: The literature supports the use of virtual reality gaming rehab therapy as equivalent to traditional therapies or as successful augmentation to those therapies. While some degree of rigor was displayed in the literature, small sample sizes, variation in study lengths and therapy durations and unequal controls reduce generalizability and comparability.
Conclusions: Future studies should incorporate larger sample sizes and post-intervention follow-up measures.

Source: Virtual reality gaming in the rehabilitation of the upper extremities post-stroke – Brain Injury | Taylor & Francis Online

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[Abstract] Does the use of Nintendo Wii SportsTM improve arm function? Trial of WiiTM in Stroke: A randomized controlled trial and economics analysis

Abstract

Objective: The Trial of Wii™ in Stroke investigated the efficacy of using the Nintendo Wii Sports™ (WiiTM) to improve affected arm function after stroke.

Design: Multicentre, pragmatic, parallel group, randomized controlled trial.

Setting: Home-based rehabilitation.

Subjects: A total of 240 participants aged 24–90 years with arm weakness following a stroke within the previous six months.

Intervention: Participants were randomly assigned to exercise daily for six weeks using the WiiTM or arm exercises at home.

Main measures: Primary outcome was change in the affected arm function at six weeks follow-up using the Action Research Arm Test. Secondary outcomes included occupational performance, quality of life, arm function at six months and a cost effectiveness analysis.

Results: The study was completed by 209 participants (87.1%). There was no significant difference in the primary outcome of affected arm function at six weeks follow-up (mean difference −1.7, 95% CI −3.9 to 0.5, p = 0.12) and no significant difference in secondary outcomes, including occupational performance, quality of life or arm function at six months, between the two groups. No serious adverse events related to the study treatment were reported. The cost effectiveness analysis showed that the WiiTM was more expensive than arm exercises £1106 (SD 1656) vs. £730 (SD 829) (probability 0.866).

Conclusion: The trial showed that the WiiTM was not superior to arm exercises in home-based rehabilitation for stroke survivors with arm weakness. The WiiTM was well tolerated but more expensive than arm exercises.

Source: Does the use of Nintendo Wii SportsTM improve arm function? Trial of WiiTM in Stroke: A randomized controlled trial and economics analysis

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[Abstract] Does the use of Nintendo Wii Sports improve arm function? Trial of Wii in Stroke: A randomized controlled trial and economics analysis

Abstract

Objective: The Trial of Wii™ in Stroke investigated the efficacy of using the Nintendo Wii Sports™ (WiiTM) to improve affected arm function after stroke.

Design: Multicentre, pragmatic, parallel group, randomized controlled trial.

Setting: Home-based rehabilitation.

Subjects: A total of 240 participants aged 24–90 years with arm weakness following a stroke within the previous six months.

Intervention: Participants were randomly assigned to exercise daily for six weeks using the WiiTM or arm exercises at home.

Main measures: Primary outcome was change in the affected arm function at six weeks follow-up using the Action Research Arm Test. Secondary outcomes included occupational performance, quality of life, arm function at six months and a cost effectiveness analysis.

Results: The study was completed by 209 participants (87.1%). There was no significant difference in the primary outcome of affected arm function at six weeks follow-up (mean difference −1.7, 95% CI −3.9 to 0.5, p = 0.12) and no significant difference in secondary outcomes, including occupational performance, quality of life or arm function at six months, between the two groups. No serious adverse events related to the study treatment were reported. The cost effectiveness analysis showed that the WiiTM was more expensive than arm exercises £1106 (SD 1656) vs. £730 (SD 829) (probability 0.866).

Conclusion: The trial showed that the WiiTM was not superior to arm exercises in home-based rehabilitation for stroke survivors with arm weakness. The WiiTM was well tolerated but more expensive than arm exercises.

Source: Does the use of Nintendo Wii SportsTM improve arm function? Trial of WiiTM in Stroke: A randomized controlled trial and economics analysis

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[Abstract] Survivors of chronic stroke – participant evaluations of commercial gaming for rehabilitation

Abstract

Purpose: There has been an increase in research on the effect that virtual reality (VR) can have on physical rehabilitation following stroke. However, research exploring participant perceptions of VR for post-stroke rehabilitation has been limited.
Method: Semi-structured interviews were conducted with 10 chronic stroke participants (10 males, mean age = 72.1, mean time since injury = 38.6 mos.) who had recently completed an upper extremity VR stroke rehabilitation programme.
Results: Four main themes emerged: ‘the VR experience,’ ‘functional outcomes,’ ‘instruction,’ and the ‘future of VR in stroke rehabilitation,’ along with nine sub-themes. Participants illustrated the positive impact that VR training had on their functional abilities as well as their confidence towards completing activities of daily living (ADL). Participants also expressed the need for increased rehabilitation opportunities within the community.
Conclusion: Overall, participants were optimistic about their experience with VR training and all reported that they had perceived functional gain. VR is an enjoyable rehabilitation tool that can increase a stroke survivor’s confidence towards completing ADL.

  • Implications for Rehabilitation

  • Although there is an increase in rehabilitation programmes geared towards those with chronic stroke, we must also consider the participants’ perception of those programmes.

  • Incorporating participant feedback may increase enjoyment and adherence to the rehabilitation programmes.

  • The VR experience, as well as provision of feedback and instruction, are important aspects to consider when developing a VR programme for stroke survivors.

  • VR for rehabilitation may be a feasible tool for increasing the survivors’ confidence in completing ADL post-stroke.

Related articles

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Source: Taylor & Francis Online

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[Abstract] The effects of Nintendo WiiTM-based balance and upper extremity training on activities of daily living and quality of life in patients with sub-acute stroke: a randomized controlled study. – PubMed

Abstract

OBJECTIVE:The aim of this study was to investigate the effects of Nintendo WiiTM-based balance and upper extremity training on activities of daily living and quality of life in patients with subacute stroke.

METHODS:42 adults with stroke (mean age (SD) = 58.04 (16.56) years and mean time since stroke (SD) = (55.2 ± 22.02 days (∼8 weeks)) were included in the study. Participants were enrolled from the rehabilitation department of a medical center (a single inpatient rehabilitation facility). Participants were randomly assigned to Nintendo Wii group (n = 20) or Bobath neurodevelopmental treatment (NDT) (n = 22). The treatments were applied for 10 weeks (45-60 minutes/day, 3 days/week) for both of two groups. Nintendo Wii group used five games selected from the Wii sports and Wii Fit packages for upper limb and balance training, respectively. The patients in Bobath NDT group were applied a therapy program included upper extremity activites, strength, balance gait and functional training. The functional independence in daily life activities and health-related quality of life was assessed with Functional Independence Measure (FIM) and Nottingham Health Profile (NHP), respectively. Participant’s treatment satisfaction was recorded by using Visual Analogue Scale. A second evaluation (FIM and NHP) occurred after 10 weeks at the end of rehabilitative treatment (post-training). Treatment satisfaction was measured after 10 sessions.

RESULTS:There were significant difference between FIM and NHP values in NDT and Nintendo Wii group (p < 0.05). However, a significant difference was not found between the groups with regard to FIM and NHP (p > 0.05). The patients in Nintendo Wii group were detected to be better satisfied from the therapy (p < 0.05). A significant difference was found between subparameters and total FIM score, all subparameters and total NHP score in both groups (p < 0.05).

CONCLUSION:These findings suggested that the Nintendo Wii training was as effective as Bobath NDT on daily living functions and quality of life in subacute stroke patients.

Source: The effects of Nintendo WiiTM-based balance and upper extremity training on activities of daily living and quality of life in patients with sub-acu… – PubMed – NCBI

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