Posts Tagged Wii
[ARTICLE] A controlled pilot trial of two commercial video games for rehabilitation of arm function after stroke
Objectives: To investigate the acceptability and potential efficacy of two commercial video games for improving upper extremity function after stroke in order to inform future sample size and study design.
Design: A controlled clinical trial design using sequential allocation into groups.
Setting: A clinical occupational therapy department.
Subjects: Twenty-four first-stroke patients.
Interventions: Patients were assigned to one of three groups: conventional group, Wii group, and XaviX group. In addition to regular one-hour conventional rehabilitation, each group received an additional half-hour of upper extremity exercises via conventional devices, Wii games, or XaviX games, for eight weeks.
Main measures: The Fugl-Meyer Assessment of motor function, Box and Block Test of Manual Dexterity, Functional Independence Measure, and upper extremity range of motion were used at baseline and postintervention. Also, a questionnaire was used to assess motivation and enjoyment.
Results: The effect size of differences in change scores between the Wii and conventional groups ranged from 0.71 (SD 0.59) to 0.28 (SD 0.58), on the Fugl-Meyer Assessment of motor function (d = 0.74) was larger than that between the XaviX and conventional groups, ranged from 0.44 (SD 0.49) to 0.28 (SD 0.58) (d = 0.30). Patient enjoyment was significantly greater in the video game groups (Wii mean 4.25, SD 0.89; XaviX mean 4.38, SD 0.52) than in the conventional group (mean 2.25, SD 0.89, F = 18.55, p < 0.001), but motivation was not significantly different across groups.
Conclusion: Patients were positive to using video games in rehabilitation. A sample size of 72 patients (24 per group) would be appropriate for a full study.
[ARTICLE] Virtual Reality Video Games to Promote Movement Recovery in Stroke Rehabilitation: A Guide for Clinicians
After stroke, people often have difficulty moving one arm and hand, but movement can improve with considerable practice. Arm movements may need to be repeated upwards of 2500 times for a person to approach his/her peak level of motor function.1 Video-gaming technology can effectively deliver engaging, high-repetition movement practice. Use of video games for rehabilitation can be as effective as more conventional approaches.2
There are 2 types of inexpensive, commonly available gaming systems that can be integrated into rehabilitation programs: controller based and camera tracking. In order for the systems to be used most effectively, it is necessary for therapists and/or individuals with stroke to assess both system types to determine which system best suits their needs and impairments.
The following are examples of systems and games that incorporate movements that may be useful for rehabilitation. This is not intended to be an exhaustive list, as new games and gaming systems are constantly being introduced to the market.
Stroke survivors can have “significant” improvement in arm movements after using the Nintendo Wii as physiotherapy according to researchers.
The popular computer remote could be customised to offer bespoke physiotherapy for stroke survivors in their own home according to research led by Lancaster University.
A preliminary study showed that playing specially adapted Wii games improved the arm movements of stroke patients, with a threefold increase in their ability to pick up and put pegs in holes.
One stroke survivor was even able to lift and drain a cooking pan for the first time since her stroke 11 years before and her hand “wanted to open of its own accord.”
There are an estimated 110,000 new strokes in the UK each year, costing more than £2.8billion, and over a third who survive are left with a long term disability.
Seven out of ten suffer from arm weakness as a result, with no more than a fifth of these ever regaining the full use of their arm.
Led by Dr Emmanuel Tsekleves of Lancaster University, the 15-month Research in Wii Rehabilitation study published in Disability and Rehabilitation was carried out at five NHS sites.
Dr Tsekleves said: “The innovative use of the Nintendo Wii could present a way to enhance community based stroke rehabilitation of the arm by providing a motivating and cost-effective way of exercising that could be remotely monitored and exercises adjusted as required by a physiotherapist.”
Participants took part in three trials using the Wii as a way of improving their arm movements after stroke. They had to imitate a 3D avatar on screen following movement patterns for the shoulder, elbow and forearm. They also had to play games that included hitting randomly appearing balls and playing air hockey on screen.
One said: “I can now play games and do things not possible for me before,” while another said: “It’s great! I can see my arm movement appear instantly on screen and can tell how well and far I have gone.”
Each patient’s movements were recorded, and the physiotherapist could remotely monitor progress and give advice as well as customise the game in terms of movement, speed, duration, scoring and feedback.
There are now plans to extend the trial which was also carried out by Ioannis Paraskevopoulos, Alyson Warland, and Cherry Kilbride of Brunel University.
[ARTICLE] Energy Expenditure and Exercise Intensity of Interactive Video Gaming in Individuals Poststroke
Background. Off-the-shelf activity-promoting video games (AVGs) are proposed as a tool for promoting regular physical activity among individuals poststroke.
Objective. To characterize the energy expenditure (EE), exercise intensity, and energy metabolism of individuals poststroke, while playing AVGs in different positions, from different consoles, and to compare the performance with comfortable walking and with able-bodied individuals.
Methods. Eleven poststroke and 8 able-bodied participants played in standing Wii-Boxing Xbox-Boxing, Wii-Run and Penguin, and also Wii-Boxing in sitting. EE (expressed as metabolic equivalents [METs]); exercise intensity (expressed as %predicted maximal heart rate [HR]), rate of perceived exertion (RPE), and respiratory exchange ratio (RER) were used to characterize the games. Results. Participants’ poststroke EE ranged from 1.81 ± 0.74 to 3.46 ± 1.3 METs and was lower compared with able-bodied participants for Xbox-Boxing (P = .001), Wii-Boxing in standing (P = .01), Run (P < .001), and Penguin (P = .001). Participants’ poststroke exercise intensity ranged from 49.8 ± 9.3 to 64.7 ± 9.3 %predicted maximal HR and was lower compared with able-bodied participants for Xbox-Boxing (P = .007) and Run (P = .005). For participants poststroke, EE of walking at a comfortable did not differ from boxing games in standing or Run. For able-bodied participants only, the EE for Xbox-Boxing was higher than Wii-Boxing (6.5 ± 2.6 vs 4.4 ± 1.1, P = .02). EE was higher in standing versus sitting for poststroke (P = .04) and able-bodied (P = .03) participants. There were no significant group differences for RPEs. RER of playing in sitting approached anaerobic metabolism.
Conclusions. Playing upper extremity (ie, Boxing) or mobility (ie, Run) AVGs in standing resulted in moderate EE and intensity for participants poststroke. EE was lower for poststroke than for able-bodied participants.