Abstract
BackgroundStroke is one of the leading causes of long-term disability in modern western countries. Stroke survivors often have functional limitations which might lead to a vicious circle of reduced physical activity, deconditioning and further physical deterioration. Current evidence suggests that routine moderate- or vigorous-intensity physical activity is essential for maintenance and improvement of health among stroke survivors. Nevertheless, long-term participation in physical activities is low among people with disabilities. Active video games, such as Nintendo Wii Sports, might maintain interest and improve long-term participation in physical activities; however, the intensity of physical activity among chronic stroke patients while playing Wii Sports is unknown. We investigated the energy expenditure of chronic stroke patients while playing Wii Sports tennis and boxing.MethodsTen chronic (≥ 6 months) stroke patients comprising a convenience sample, who were able to walk independently on level ground, were recruited from a rehabilitation centre. They were instructed to play Wii Sports tennis and boxing in random order for 15 minutes each, with a 10-minute break between games. A portable gas analyzer was used to measure oxygen uptake (VO2) during sitting and during Wii Sports game play. Energy expenditure was expressed in metabolic equivalents (METs), calculated as VO2 during Wii Sports divided by VO2 during sitting. We classified physical activity as moderate (3-6 METs) or vigorous (> 6 METs) according to the American College of Sports Medicine and the American Heart Association Guidelines.ResultsAmong the 10 chronic stroke patients, 3 were unable to play tennis because they had problems with timing of hitting the ball, and 2 were excluded from the boxing group because of a technical problem with the portable gas analyzer. The mean (± SD) energy expenditure during Wii Sports game play was 3.7 (± 0.6) METs for tennis and 4.1 (± 0.7) METs for boxing. All 8 participants who played boxing and 6 of the 7 who played tennis attained energy expenditures > 3 METs.ConclusionsWith the exception of one patient in the tennis group, chronic stroke patients played Wii Sports tennis and boxing at moderate-intensity, sufficient for maintaining and improving health in this population.
Highlights
Stroke is one of the leading causes of long-term disability in modern western countries
Recommend that routine moderate- or vigorous-intensity physical activity is needed for stroke survivors to improve and maintain their health [4,14]
Patient characteristics were collected from the patient file, including demographics, stroke severity using the Bamford scale [25], upper extremity strength and spasticity from the affected side using de Medical Research Council (MRC) scale [26] and the Modified Ashworth Scale [27], balance using the Berg Balance Scale (BBS) [28], and disability based on the Modified Rankin Scale [29]
Summary
Stroke is one of the leading causes of long-term disability in modern western countries. Stroke survivors often have functional limitations which might lead to a vicious circle of reduced physical activity, deconditioning and further physical deterioration. Low aerobic capacity compromises functional mobility after stroke [7,8] This might lead to a vicious circle of physical inactivity and further physical deterioration [4,9]. Recommend that routine moderate- or vigorous-intensity physical activity is needed for stroke survivors to improve and maintain their health [4,14]. Long-term participation in physical activities is low among people with disabilities as a result of person related factors (e.g. reduced mobility, social isolation) and environmental factors (e.g. limited access to stores and buildings, transport, and availability of equipment) [4,15,16,17]
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