Nintendo Wii Research Articles

Comparação da frequência cardíaca e percepção subjetiva de esforço entre o Tênis de mesa e o game table Tennis nos consoles Xbox Kinect e Nintendo Wii

O estudo objetivou verificar e comparar a frequência cardíaca (FC) e a percepção subjetiva de esforço (PSE) durante o gameplay entre o Tênis de Mesa (TM) e o game do table tennis nos consoles Kinect Xbox (TTK) e no Nintendo Wii (TTW). Participaram do estudo 12 homens com 21,8 ± 3,1 (anos), 81 ± 11,24 (kg) e 176 ± 7 (cm). Os games geraram valores similares de FC média em TTW (83,67 ± 16,7 bpm) e TTK (89,67 ± 16,32 bpm), mas durante o TM foi observada demanda cardiovascular superior (103,50 ± 23,9 bpm). A PSE média encontrada no TTW (1,5 ± 0,67 ua) foi estatisticamente menor que no TM (2,67 ± 0,78 ua), mas não diferiu do TTK (2 ± 1,04 us). Os resultados sugerem que o Tênis de Mesa virtual, em ambos consoles, não é eficiente para aumentar a demanda cardiovascular.

Home-based balance training using Wii Fit\u2122: a pilot randomised controlled trial with mobile older stroke survivors

BackgroundSeveral studies have reported that using the Wii™ Balance Board can provide added value regarding balance (re-)training in neurological diseases. However, for the large group of mobile older stroke survivors, there is no evidence regarding the feasibility of an unsupervised Wii™ Balance Board training in the home setting. The aim of this study was to investigate the feasibility of a home-based Wii™ balance training for these patients and to identify methodological challenges for randomised controlled trials in the future.MethodsWe conducted a pilot randomised controlled trial with two intervention arms in participants’ homes. Mobile stroke survivors (aged 60 years or above; 12 weeks after discharge from hospital) received a 6-week (once per week) supervised balance training at the study centre, followed by a 6-week (three times per week) unsupervised balance training at home. We used the Nintendo Wii™ Balance Board for one intervention arm and conventional balance exercises for the other intervention arm. Feasibility was assessed by recruiting rates, appropriateness of assessments regarding sensitivity to changes and acceptance of the intervention by the participants.ResultsIn two German hospital stroke units, 349 stroke survivors were screened over a period of 6 months, 91 were eligible and 52 were interested. Twelve weeks after discharge, 14 participants agreed and 11 completed the intervention (7 men and 4 women, mean age 74 years). The Berg Balance Scale and Dynamic Gait Index showed ceiling effects already at baseline measure. The participants in both intervention arms evaluated the unsupervised training positively and feasible for self-application. No falls or injuries occurred over the intervention period, while the required scope of the exercises could largely be achieved.ConclusionsIn this pilot study, the recruitment of participants and the chosen assessments were not satisfactory due to selection bias and corresponding ceiling effects. However, the two home-based balance interventions proved feasible for mobile older stroke survivors with low functional limitations.Trial registrationClinicalTrials.gov, NCT02251470. Registered 29 September 2014

Can Wii Balance? Evaluating a Stepping Game for Older Adults.

Decline in balance control is an issue for older adults as it leads to an increased risk of falling which may result in serious injury. Mitigating this risk may be achieved through balance training and exercise, but lack of adherence to an exercise program often occurs. Improvement in balance control may be difficult to quantify in an unbiased manner given the therapist providing the treatment also assesses the patient. We developed a gamified system using an off-the-shelf technology through an iterative feedback with therapists and clients to evaluate a response time during stepping as a measure of balance control. The game was designed using serious game strategies to increase participant engagement. This game included two Nintendo Wii balance boards between which the individual was required to step while the times were recorded. To provide evidence that the system could be used in a clinical environment, we conducted a cross-sectional study collecting data for five minutes at the beginning of a physiotherapy assessment. One hundred and four individuals older than 50 years of age were recruited who were able to step forward with or without an aid. The response time for a step using the system was negatively correlated to the Berg balance score.

Efeito de video games ativos sobre a capacidade funcional e o humor de idosos: revisão sistemática e meta-análise


 
 
 Nos últimos anos, os video games ativos (VGAs) têm sido utilizados pela população geral como uma alternativa para a prática de exercício físico associada ao entretenimento. O objetivo deste estudo foi realizar uma revisão sistemática sobre o efeito dos VGAs na capacidade funcional e no estado de humor de idosos. Para a seleção dos artigos, considerou-se estudos publicados entre 2006 e 2017, realizados com idosos (> 60 anos); que utilizaram como intervenção, exercícios realizados em VGAs Nintendo Wii ou Xbox Kinect. Os resultados observados sugerem melhoras no equilíbrio, na força muscular de membros inferiores e na mobilidade funcional. No perfil de humor, os resultados são controversos. Sendo assim, podemos concluir que o exercício realizado em VGAs pode melhorar a capacidade funcional, no entanto, os benefícios no humor precisam ser mais investigados, especialmente em estudos de longo prazo.
 
 

The effects of virtual reality on the rehabilitation of patients with knee OA: A randomized controlled clinical trial

Knee OA is one of the most prevalent orthopedic diseases in the elderly population, with a degenerative and progressive character that affects the articular cartilage, limiting the articular range of motion (ROM) due to rigidity and causing important functional restrictions. Virtual reality (VR) is one of the instruments that can help in the rehabilitation process of patients, motivating them and enabling more assertive movements and exercises. Ninety patients (65 women and 25 men) between 50 and 70 years old, with a medical diagnosis of OA in at least one knee participated in the study. After completing the WOMAC and Lequesne questionnaires, they were evaluated for pain and muscular strength. The volunteers signed the consent term and were then randomly divided, using opaque, sealed envelopes, into 3 groups: control group - performed a conventional physiotherapy program with aerobic and muscle strengthening exercises; experimental group 1 (Wii) - in addition to the conventional program used Nintendo's Wii Fit games; experimental group 2 (Kinect) - complemented the conventional treatment with the Xbox Kinect video game system. It was observed that, in general, the three study groups demonstrated statistically significant improvement ( P < 0.05) in relation to pain and muscular strength. The groups with inclusion of the VR resources only presented better results than the control group in the function dimension of the WOMAC questionnaire. The methodological conditions used in the study suggest that virtual reality as an additional instrument in rehabilitation programs for patients with knee OA was better than the control group only in the function dimension of the WOMAC questionnaire.

Amount (activity and mobility using technology) rehabilitation trial: Technologies used and participant perceptions in the inpatient setting

New technologies may provide an affordable way to increase the dose of practice for people undertaking rehabilitation. Study aims: (1) Which technologies were used to address participants’ mobility limitations during the inpatient phase of the AMOUNT rehabilitation trial? (2) Did participants perceive technologies to be enjoyable and easy to use, and which factors influenced this? Design: process evaluation from a randomised controlled trial in which 149 participants [52% male; mean age 70 (SD18); 54% neurological conditions] were allocated to the intervention group. Intervention: tailored technology prescription according to a protocol matching exercises from eight technologies (commercially-available: Nintendo Wii; Xbox Kinect; activity monitors; smartphone apps; rehabilitation-specific Humac; Fysiogaming; Stepping Tiles; exercise iPad apps) to seven mobility limitations. Outcome measures: intervention dose, technologies used, mobility limitations addressed, Physical Activity Enjoyment (PACES; 18–126) and System Usability Scales (SUS; 0–100). Participants received on average 11 (SD11) sessions of 43 (SD11) minutes duration. Each participant used on average 4 (SD1) technologies to address a mean of 4 (SD1) different mobility limitations. Intervention focused largely on limitations related to standing (80%) and stepping (79%), as well as on physical activity levels (90%). The Humac was the most frequent first-introduced technology (35% of participants). Activity monitors (80%) and iPad apps (71%) were most prescribed, and commercially-available exergames and smartphone apps used least. At 3 weeks, participants perceived technology use as enjoyable [mean PACES 95.4 (SD23.2)] and rated usability above average [mean SUS 72.2 (SD18.8)]. Enjoyment and usability were positively related to previous technology use ( P < 0.01) and younger age ( P ≤ 0.03). Usability was greater in those with neurological conditions ( P < 0.05). Previous technology use remained associated with usability after adjustment for other factors ( P = 0.003). In inpatient rehabilitation, tailored prescription of technologies can address a range of mobility limitations and was well accepted. Previous technology use enhances uptake.

Two models of virtual reality devices for therapeutics in persons with cerebral palsy

Virtual reality based therapy (VRBT) refers to the use of interactive simulations to present users with opportunities to perform neurorehabilitation in virtual environments that appear, sound, and less frequently, feel similar to real-world objects and events. This study compared the effects of 2 off-the-shelf gaming system devices on standing balance and weight shifting for persons with Cerebral Palsy (PWCP) following single event multilevel lever arm restoration and anti spasticity surgery (SEMLARASS). A prospective experimental study was conducted among 80 PWCP post SEMLARASS aged 5–20 years and randomly assigned into Group A (n = 40): received the VRBT with Xbox 360 with Kinect (XwK) and Group B (n = 40): received the VRBT with Nintendo Wii with Balance Board (WwB). The study duration was 5 weeks with 30 minutes of intervention per day for 6 days per week in each group. A total of 3 games (5 choices) were played per session supervised by a physiotherapist. Paediatric Balance Scale (PBS) and Dynamic Gait Index (DGI) were the primary outcome measures, performed at baseline, 5 weeks after the treatment and follow-ups after 1 month and 3 months. The additional outcomes measured were walking test, steadiness test, COG and single-leg standing test using the stabilometer of the Wii balance board. Both the groups improved significantly after the intervention. However, Group A showed significant difference in PBS (P < 0.01) and DGI (P < 0.05) when compared to group B. The obtained outcomes were maintained at 1 month and 3 months follow-up. The X box 360 had a better connect to the virtual in comparison to the Nintendo Wii as reported by the users. While both devices were found effective, VRBT with XwKwas superior toWwB for improving standing balance and weight shifting in CWCP after SEMLARASS.

Sit-to-stand movement score for the identification of a locomotive syndrome using the Nintendo Wii balance board

The Japanese Orthopaedic Association proposed the term “locomotive syndrome” (LS) to define people at risk of requiring nursing care because of problems with their locomotive system. There is a need to develop simple methods to quantify motor performance and the early detection of LS. Sit-to-stand (STS) movements are a mechanically demanding task in everyday activities and represent motor performance. In the present study, we have developed a novel method to quantify STS movements (STS score) using ground reaction force and center of pressure data from the Nintendo Wii Balance Board (WBB). We investigated whether the STS score can predict LS. The study enrolled 155 subjects aged over 65 years. Individuals were divided into three groups based on LS risk tests results. The subjects were instructed to stand up as quickly as possible on the WBB, and the STS score was calculated as the combination of the speed and balance indices. We also performed a timed up and go test and hand-grip strength test to evaluate the motor status. There were significant differences in each test among the groups ( Table 1 ). The STS score significantly decreased with the severity of LS and thus could be used to assess LS in elder people.

Validity of the Nintendo Wii Balance Board for the Assessment of Balance Measures in the Functional Reach Test.

The functional reach test (FRT) is widely used for assessing dynamic balance stability in elderly and pathological subjects. Force platforms (FPs) represent a fundamental part of the instrumented FRT experimental setup due to the central role of center-of-pressure (COP) displacement in FRT analysis. Recently, the nintendo wii balance board (NBB) has been suggested as a low-cost and reliable device for ground reaction force and COP measurement in poorly dynamic motor tasks. Therefore, this paper aimed to compare NBB-COP data with those obtained from a laboratory-grade platform during FRT. Data from 48 healthy subjects were simultaneously acquired from both devices. FP-COP and NBB-COP trajectories showed a remarkable correlation in both directions ( ) and low root-mean-square error values (1.14 ± 0.88 mm and 0.55 ± 0.28 mm for anterior-posterior and medial-lateral direction). Fixed biases between COP-based parameters did not exceed 2% of the FP outcomes with high consistency throughout the present measurement range (ICC consistency always >0.950). Only the COP mean velocity exhibited a tendency toward proportional errors, which can be adjusted by a calibration of NBB data. Findings of this paper confirmed the NBB validity for COP measurement in a widely used motor task as the functional reach, supporting the feasibility of NBB in research scenarios.

Efeito de um programa de gameterapia no equilíbrio de idosos

Introduo: a gameterapia uma interveno que promove a melhora do equilbrio em idosos. Objetivos: verificar a eficcia da utilizao de gameterapia em Nintendo WII para melhora do equilbrio de idosos. Mtodos: trata-se de um estudo piloto com 10 idosos de ambos os sexos. Foram aplicados testes especficos como Escala de Equilbrio de Berg, Teste Timed Up and Go e Teste do Alcance Funcional e aps realizado a gameterapia por meio de jogos de esporte, agilidade e raciocnio do Nintendo WII. Foi utilizado o teste t de student dependente um nvel de significncia de p 0,05. Resultados: ao comparar o efeito do programa de treinamento de Nintendo WII no equilbrio dos idosos, verificou-se diferena significativa (p 0,05) em todos os testes de equilbrio, evidenciando que o programa de interveno baseado no Nintendo WII teve um efeito positivo sobre o equilbrio dos idosos. Concluso: a gameterapia por meio do Nintendo WII proporcionou aos idosos melhora do seu equilbrio.

The Social Effects of Exergames on Older Adults: Systematic Review and Metric Analysis.

BackgroundRecently, many studies have been conducted to investigate the effects of exergames on the social well-being of older adults.ObjectiveThe aim of this paper is to synthesize existing studies and provide an overall picture on the social effects of exergames on older adults.MethodsA comprehensive literature search with inclusive criteria was conducted in major social science bibliographic databases. The characteristics of exergames, participants, methodology, as well as outcome measurements were extracted from the relevant studies included in the review. The bibliometric and altmetric outreach of the included studies were also investigated.ResultsA total of 10 studies were included in the review, with 8 studies having used the Nintendo Wii platform. Most of the studies recruited healthy older adults from local communities or senior activity centers. Three groups of social-related outcomes have been identified, including emotion-related, behavior-related, and attitude-related outcomes. A metric analysis has shown that the emotion-related and behavior-related outcomes received high attention from both the academic community and social media platforms.ConclusionsOverall, the majority of exergame studies demonstrated promising results for enhanced social well-being, such as reduction of loneliness, increased social connection, and positive attitudes towards others. The paper also provided implications for health care researchers and exergame designers.

Training healthy persons and individuals with Parkinson's disease to use Xbox Kinect games: a preliminary study

Background/Aims: Individuals with Parkinson's disease, besides the motor and cognitive symptoms may even present deficits in the motor learning. A recent therapeutic approach involves virtual reality that offers elements that can minimize the difficulties in the learning process. Recently, the therapeutic potential of Nintendo Wii® gaming device for rehabilitation of patients with Parkinson's disease has been showing positive results, but studies related to the use of the Kinect for XboxTM are still scarce. The present study aimed to investigate the effects of motor and cognitive demands of six Kinect for Xbox 360TM games on the learning of patients with Parkinson's disease, comparing it with healthy individuals. Methods: A total of 19 adults, 8 with idiopathic Parkinson's disease and 11 healthy adults participated in a program which included 10 training sessions and had their scores registered three times. Findings: The results showed that in four of those games, patients with Parkinson's disease showed an ability to improve and keep their performance, but not in the other two games, similar to healthy adults. Conclusions: It was concluded that motor and cognitive abilities affected by Parkinson's disease may be improved with the use of virtual training proposed in this study. Some of the games and gaming devices features can influence the learning process, even in healthy adults.

A Systematic Review and Meta-analyis on the Effect of Training with Nintendo Wii TM in the Improvement of Basic Laparoscopic Skills Among Laparoscopic Novices

Introduction: Videogames offer the usual skills needed for laparoscopy namely, eye-hand coordination, depth perception, and bimanual operation. The impact of playing videogames on basic laparoscopic skills is still ambiguous with some studies showing correlation and with other studies demonstrating little or no effect. Objective: To determine the impact of training with Nintendo® WiiTM in the improvement of basic laparoscopic skill among laparoscopic novices by measuring the time to completion of eyehand coordination task, two-hand manipulation task, grasping and cutting task or grasping and clipping tasks. Methods: An electronic systematic search was done in online databases and search engines. This review included randomized prospective studies, written in English language, and published within the last 5 years. Participants included adults 19-29 years old, medical students and surgical residents, with a low video game experience, without or minimal experience in laparoscopic surgery and laparoscopic simulator. The studies compared the performance of participants in a laparoscopic simulator (SimbionixTM LapMentorTM or ProMIS) after training with Nintendo® WiiTM and measured their completion time of several tasks. Results: Training with Nintendo® WiiTM showed improvement in time to completion of eye-hand coordination task, two-hand manipulation task, and grasping and clipping task. The study however showed equivocal results in the grasping and cutting tasks Conclusion: Training with Nintendo® WiiTM can be used as a training tool for the improvement of basic laparoscopic skills of laparoscopic novices. Key words: Nintendo® WiiTM, surgical skills, laparoscopic skills

Day-to-Day Variability of Postural Sway and Its Association With Cognitive Function in Older Adults: A Pilot Study.

Introduction: Increased variability in motor function has been observed during the initial stages of cognitive decline. However, the natural variability of postural control, as well as its association with cognitive status and decline, remains unknown. The objective of this pilot study was to characterize the day-to-day variability in postural sway in non-demented older adults. We hypothesized that older adults with a lower cognitive status would have higher day-to-day variability in postural sway.Materials and Methods: A Nintendo Wii balance board (WBB) was used to quantify postural sway in the home twice daily for 30 days in 20 non-demented, community-dwelling older adults: once under a single-task condition and once under a dual-task condition (using a daily word search task administered via a Nook tablet). Mean sway distance, velocity, area, centroidal frequency and frequency dispersion were derived from the center of pressure data acquired from the WBB.Results: Linear relationships were observed between the day-to-day variability in postural sway and cognitive status (indexed by cognitive global z-scores). More variability in time-domain postural sway (sway distance and area) and less variability in frequency-domain postural sway (centroidal sway frequency) were associated with a lower cognitive status under both the single- and dual-task conditions. Additionally, lower cognitive performance rates on the daily word search task were related to a lower cognitive status.Discussion: This small pilot study conducted on a short time scale motivates large-scale implementations over more extended time periods. Tracking longitudinal changes in postural sway may further our understanding of early-stage postural decline and its association with cognitive decline and, in turn, may aid in the early detection of dementia during preclinical stages when the utility of disease-modifying therapies would be greatest.

Effect of Training Level on a Visuomotor Balance Task in Youth with Previous Sport-Related Concussion.

INTRODUCTION: The demands of sport require the integration of cognition and sensory inputs to produce more complex, goal-directed movement. Howell and colleagues (1) revealed that the differences in balance control between athletes with or without previous concussion were greater in youth compared young adults during dual-task gait. PURPOSE: 1) To determine if a novel visuomotor dynamic balance task can objectively identify differences between youth hockey players with/without sport-related concussion (SRC); and 2) If there are balance control differences between players who participate in minor hockey and private hockey academy training. METHODS: Youth hockey players (N=47; age=12-17 years), who reported previous SRC (n=17) and CONTROL (n=30). Group 1 was from a minor hockey team (SRC1=4; CONTROL1=12) and group 2 a private hockey academy (SRC2=13, CONTROL2=18). Participants stood in single support on a Nintendo Wii Balance board sampled at 100Hz and performed a lower limb reaching task with their non-stance foot. Five FitLights were arranged on the floor anteriorly at +60°, +30°, and 0° and were used as Go(GREEN)/No-Go(RED) stimuli. Balance control was assessed using RMS velocity of COP (vCOP) in anterior-posterior (A/P) and medial-lateral (M/L) planes. RESULTS: There were significant differences for both A/P vCOP (SRC= 8.04cm/s; CONTROL= 11.04cm/s, p <.05) and M/L vCOP (SRC= 6.27cm/s; CONTROL= 7.72cm/s, p <.05), as the SRC group performed the task slower than CONTROL There were no significant differences between SRC1 and SRC2 in vCOP A/P (p=0.50) or M/L (p=0.26) likewise for CONTROL1 and CONTROL2 vCOP A/P (p=0.88) and M/L (p=0.97). CONCLUSION: The assessment of a visuomotor dynamic balance task can objectively identify youth athletes with previous history of SRC regardless of training levels. Incorporating cognitive-motor tasks may help to improve balance control deficits in youth post-SRC and ensure true readiness for return-to-sport. 1. Howell DR, Osternig LR, Chou LS. Adolescents demonstrate greater gait balance control deficits after concussion than young adults. The American journal of sports medicine. 2015 Mar;43(3):625-32.

The Effect Of Goal Structure On Vo2 And Motivation In 6-10 Year Old Children During Exergame Play

Previous research has examined contexts which may promote playing physically interactive video games (exergames) in place of traditional, sedentary video games in children. In one such study the presence of a friend did not increase children’s motivation to play an exergame versus a sedentary alternative. This lack of an effect may have been due to the competitive goal structure of the exergame studied. Children may prefer a cooperative game structure when playing with a friend. PURPOSE: To examine physiologic response and relative reinforcing value (RRV, i.e., motivation) for playing an exergame with a friend under two different goal structures: competitive and cooperative. METHODS: Participants (N = 7, 7.9 ± 1.5 years old) and a same-sex friend each completed three, 10-minute conditions: supine rest, competitive, and cooperative game play. During competitive game play, participants played Nintendo Wii Tennis against their friend. During the cooperative condition, subjects and their friend played together against a computer avatar. During each 10 minute session oxygen consumption (VO ml[BULLET OPERATOR]kg-1[BULLET OPERATOR]min-1) was recorded and children reported their liking, via visual analog scale, for that condition. After completing all three conditions, children completed an RRV computer task to assess their motivation to play the competitive versus cooperative goal structures. During the task children performed work (button presses) to gain access to competitive play, cooperative play or a combination of the two. The output maximum (Omax) or maximum amount of work (presses) for each goal structure was used as the measure of RRV. RESULTS: VO2 was significantly (p ≤ 0.009) greater for cooperative (8.88 ± 3.29 ml[BULLET OPERATOR]kg-1[BULLET OPERATOR]min-1) and competitive (10.24 ± 3.24 ml[BULLET OPERATOR]kg-1[BULLET OPERATOR]min-1) game play than the resting condition (5.75 ± 1.59ml[BULLET OPERATOR]kg-1[BULLET OPERATOR]min-1). Liking was also significantly (p ≤ 0.004) greater for cooperative (8.92 ± 2.03 cm) and competitive (8.59 ± 2.39 cm) game play than rest (3.07 ± 2.59 cm). There were no differences (p > 0.05) between cooperative and competitive game play for: VO2, liking, or Omax. CONCLUSION: In children, VO2 and liking were both greater during exergame play versus the resting condition. However, motivation to play the competitive and cooperative game structures was not significantly different.

Reliability and feasibility of gait initiation centre-of-pressure excursions using a Wii\xae Balance Board in older adults at risk of falling

BackgroundImpairments in dynamic balance have a detrimental effect in older adults at risk of falls (OARF). Gait initiation (GI) is a challenging transitional movement. Centre of pressure (COP) excursions using force plates have been used to measure GI performance. The Nintendo Wii Balance Board (WBB) offers an alternative to a standard force plate for the measurement of CoP excursion.AimsTo determine the reliability of COP excursions using the WBB, and its feasibility within a 4-week strength and balance intervention (SBI) treating OARF.MethodsTen OARF subjects attending SBI and ten young healthy adults, each performed three GI trials after 10 s of quiet stance from a standardised foot position (shoulder width) before walking forward 3 m to pick up an object. Averaged COP mediolateral (ML) and anteroposterior (AP) excursions (distance) and path-length time (GI-onset to first toe-off) were analysed.ResultsWBB ML (0.866) and AP COP excursion (0.895) reliability (ICC3,1) was excellent, and COP path-length reliability was fair (0.517). Compared to OARF, healthy subjects presented with larger COP excursion in both directions and shorter COP path length. OARF subjects meaningfully improved their timed-up-and-go and ML COP excursion between weeks 1–4, while AP COP excursions, path length, and confidence-in-balance remained stable.DiscussionCOP path length and excursion directions probably measure different GI postural control attributes. Limitations in WBB accuracy and precision in transition tasks needs to be established before it can be used clinically to measure postural aspects of GI viably.ConclusionsThe WBB could provide valuable clinical evaluation of balance function in OARF.

Identification of New Tools to Predict Surgical Performance of Novices using a Plastic Surgery Simulator

To identify new tools capable of predicting surgical performance of novices on an augmentation mammoplasty simulator. The pace of technical skills acquisition varies between residents and may necessitate more time than that allotted by residency training before reaching competence. Identifying applicants with superior innate technical abilities might shorten learning curves and the time to reach competence. The objective of this study is to identify new tools that could predict surgical performance of novices on a mammoplasty simulator. We recruited 14 medical students and recorded their performance in 2 skill-games: Mikado and Perplexus Epic, and in 2 video games: Star War Racer (Sony Playstation 3) and Super Monkey Ball 2 (Nintendo Wii). Then, each participant performed an augmentation mammoplasty procedure on a Mammoplasty Part-task Trainer, which allows the simulation of the essential steps of the procedure. The average age of participants was 25.4 years. Correlation studies showed significant association between Perplexus Epic, Star Wars Racer, Super Monkey Ball scores and the modified OSATS score with rs = 0.8491 (p < 0.001), rs = -0.6941 (p = 0.005), and rs = 0.7309 (p < 0.003), but not with the Mikado score rs = -0.0255 (p = 0.9). Linear regressions were strongest for Perplexus Epic and Super Monkey Ball scores with coefficients of determination of 0.59 and 0.55, respectively. A combined score (Perplexus/Super-Monkey-Ball) was computed and showed a significant correlation with the modified OSATS score having an rs = 0.8107 (p < 0.001) and R2 = 0.75, respectively. This study identified a combination of skill games that correlated to better performance of novices on a surgical simulator. With refinement, such tools could serve to help screen plastic surgery applicants and identify those with higher surgical performance predictors.

Handgrip force steadiness in young and older adults: a reproducibility study

BackgroundForce steadiness is a quantitative measure of the ability to control muscle tonus. It is an independent predictor of functional performance and has shown to correlate well with different degrees of motor impairment following stroke. Despite being clinically relevant, few studies have assessed the validity of measuring force steadiness. The aim of this study was to explore the reproducibility of handgrip force steadiness, and to assess age difference in steadiness.MethodIntrarater reproducibility (the degree to which a rating gives consistent result on separate occasions) was investigated in a test-retest design with seven days between sessions. Ten young and thirty older adults were recruited and handgrip steadiness was tested at 5%, 10% and 25% of maximum voluntary contraction (MVC) using Nintendo Wii Balance Board (WBB). Coefficients of variation were calculated from the mean force produced (CVM) and the target force (CVT). Area between the force curve and the target force line (Area) was also calculated. For the older adults we explored reliability using intraclass correlation coefficient (ICC) and agreement using standard error of measurement (SEM), limits of agreement (LOA) and smallest real difference (SRD).ResultsA systematic improvement in handgrip steadiness was found between sessions for all measures (CVM, CVT, Area). CVM and CVT at 5% of MVC showed good to high reliability, while Area had poor reliability for all percentages of MVC. Averaged ICC for CVM, CVT and Area was 0.815, 0.806 and 0.464, respectively. Averaged ICC on 5%, 10%, and 25% of MVC was 0.751, 0.667 and 0.668, respectively. Measures of agreement showed similar trends with better results for CVM and CVT than for Area. Young adults had better handgrip steadiness than older adults across all measures.ConclusionThe CVM and CVT measures demonstrated good reproducibility at lower percentages of MVC using the WBB, and could become relevant measures in the clinical setting. The Area measure had poor reproducibility. Young adults have better handgrip steadiness than old adults.

Basal Ganglia and Prefrontal Regions Influence Postural Control and Cognitive Impairment in Parkinson's Disease

ObjectivePostural instability is one of clinical manifestations caused by the deterioration of basal ganglia (BG) in Parkinson's disease (PD). It has frequently been found in moderate and advanced stages of the disease, simultaneously, impairments of cognition and executive function are also commonly present. Several studies reported interferences between postural control and cognitive tasks passing the prefrontal regions. We aimed to reveal the roles of BG and prefrontal regions in postural control and cognitive impairment in PD patients who exhibit freezing of gait (FOG).MethodsWe measured postural control in 60 patients with Parkinson's disease (PD) in on‐medication (39 PD patients with FOG and 21 PD patients without FOG). A Nintendo Wii balance board was utilized to measure postural stability in terms of center of pressure (CoP). A modified Hoehn and Yahr scale (H&amp;Y) was used to classify clinical staging of PD. Subjects' disease severities were evaluated by using Unified Parkinson's Disease Rating Scale (UPDRS) (part III). Levodopa Equivalent Dose (LED), New Freezing of Gait questionnaire (NFOG‐Q), and Montreal Cognitive Assessment were also assessed. The participants were instructed to stand naturally on the balance platform and look at a marker, which was 3 meters from the board. The subjects were asked to perform counting days backward for a total of 170 seconds. A computer program collected the data automatically (Buated, W., et.al. Gerontology and Geriatric Medicine, 2016). Regression analysis were performed for posturographic and clinical variables to identify relationships of mild cognitive impairment, postural instability and FOG. An important parameter of CoP; path length (PL), which was found to be dominant factor of the balance analysis (Buated, W., et al. The 19th International Congress of Parkinson's Disease and Movement Disorders, 2015), was also calculated. Principal component analysis was used to analyze all clinical variables and determined the statistical significance of the variance.ResultsAssociations between PL and clinical variables were observed in all patients; LED (R2 = 0.150, p = 0.001), H&amp;Y (R2 = 0.060, p = 0.060), duration of disease (R2 = 0.065, p &lt; 0.049) and NFOG‐Q (R2 = 0.108, p = 0.010). In PD patients with FOG, relationship was found in LED (R2 = 0.125, p = 0.032). On the other hand, no relationship was noticed in PD patients without FOG.ConclusionsBasal ganglia and prefrontal regions play important roles in postural control and cognitive function in PD patients. Freezing of gait (FOG), cognitive impairment and postural control are associated with the effects of medication. Among the clinical variables, the correlation between LED and PL was found to be most important. These influences of the interruption of the neural circuitry were expressed in the postural control of PD patients, especially those subjects with FOG symptoms.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.