Video-based exergaming versus conventional rehabilitation on balance in pediatric brain tumor survivors: a randomized clinical trial

Abstract

Balance problems are widely reported in Pediatric Brain Tumor Survivors (PBTS) due to tumor localization and the side effects of medical treatment. This study investigates the effects of conventional versus video-based games exercise training (exergaming) on balance in PBTS. The present study was a randomized controlled trial. The study included 23 PBTS who were randomized to a Video-Based balance exergaming Group (VBG) or Conventional balance exercise training Group (CG). In both groups, the interventions were targeted to the balance function and balance exercise training was administered twice a week for 8 weeks. VBG exercised using selected Nintendo Wii Fit Plus® balance games while CG received a specially designed balance training using conventional physiotherapy methods. The primary outcome was the balance tests (Timed Up and Go and Nintendo® Wii™ Center of Gravity: COG), and the secondary outcomes were the functional tests (10-m walking, 2-min walking, 5-step climb/descent/times), and disease effect test (PedsQL Brain Tumor Module). The outcomes were assessed before and after the intervention. At baseline, no significant clinical and outcome assessment differences existed between both groups except for COG (p = 0.0495). After training, overall scores for balance, functional, disease effect tests significantly improved in VBG (p < 0.05) while progress observed in CG was not significant (p > 0.05). Video-based balance exergaming was found effective and more so than conventional balance exercise training in PBTS. Greater effectiveness of exergaming is thought to be due to increased motivation and effort of the children who are more attracted to gaming than conventional exercising. Exergaming could be beneficial both in clinical and home settings with physiotherapist supervision and may reduce the costs of treatment while improving their health-related quality of life.