Wii Fit Plus Research Articles

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

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.

The Effect of Wii Training on Neurocognitive Function in Athletes with Functional Ankle Instability: Matched Randomized Clinical Trial.

Many studies have investigated ankle sprain injury and it has been reported that in 80% of cases, ankle sprains lead to functional ankle instability (FAI). The conventional exercises for FAI rehabilitation neglect the associated neurocognitive dysfunction. This study aims to evaluate the effect of Wii Fit Plus as a virtual reality training on neurocognitive function in athletes with FAI compared to athletes without FAI. In this matched randomized clinical trial study, 25 athletes with unilateral FAI and 25 athletes without FAI were assigned to two groups randomly: 1) the intervention group, subjects performed the Wii training including balance and strengthening games three times a week for 12 sessions and 2) subjects in the control group received no intervention. Before and after the training, the neurocognitive function was assessed through the computerized-reaction time test based on the detection or identification of 'X' mark on a computer monitor. Between-groups and within-group comparisons were done by the independent T-test and paired T-test, respectively. A significant difference was observed in mean differences of neurocognitive function between athletes with and without FAI. Comprising before and after training was significant in the intervention group. Based on the results, the information-processing speed of athletes with FAI increased after the training, utilized for rehabilitation protocols.

Effectiveness of a perceptual - proprioceptive training with virtual visual feedback in healthy subjects: a pilot study

&#x0D; Background: the aim of this pilot study was to evaluate whether proprioceptive-motor training using the Wii Balance Board (WBB) might improve postural sway in healthy subjects.&#x0D; Methods: twenty-five healthy subjects were trained for six weeks (two sessions per week) with 5 “video games”: Wii Fit Plus (WFP) program. Before and after training: Basic Balance, Single-leg Balance, Agility, Stability and Motion (lower limb: right-left and both leg) were measured using the Wii Balance Board.&#x0D; Results: the Wilcoxon Test showed improvements at the end of the training program compared to the baseline conditions. Basic Balance increased during the WFP (33.33%) and was associated with a 19.92% decrease in center of pressure (COP) lenght. The Single-leg Balance results incremented after the WFP (left 29.09% vs. right 47.92%) and accompanied by a decrement in COP (left 28.71% vs. right 30.45%). The values for the Agility test increased both in WFP and COP (28.57% and 58.57%, respectively). The Stability test scores increased in the WFP (66.67%) along with a consequent decrease in COP (10.53%). Finally, the Motion test values increased in the WFP (73.17%), whilst COP for this test decreased (12.02%). These results indicate that 6 weeks of virtual training produced a good adaptability. Younger participants (&lt;20 years) demonstrated to be more responsive to dynamic stimulation with respect to those &gt;20 years.&#x0D; Conclusions: significant improvements in all participants were observed, indicating that virtual training can influence posture and balance in healthy people. Because of its characteristics of low cost and easy availability, a portable system for balance training for everyone offers the possibility to more readily measure motor skill and to gauge improvement.&#x0D;

Effect of virtual reality-based exercise intervention on sleep quality in children with acute lymphoblastic leukemia and healthy siblings: A randomized controlled trial.

Sleep is one of the important measurements of the quality of life for children especially suffering from a chronic illness such as cancer. Our aim was to determine the changes in sleep quality and to investigate the effect of virtual reality-based exercise (VRBE) approaches on sleep in patients with acute lymphoblastic leukemia (ALL) off treatment. The participants (ALL and healthy siblings) were evaluated for sleep quality with polysomnography and "Children's Sleep Habit Questionnaire" before and after 12 weeks. The study randomized into two groups: an exercise group who received VRBE in two days in a week, 45 min of each session for 12 weeks and an control group who were managed with supportive measures. The VRBE comprised of aerobic exercise in four different games by Nintendo Wii Fit Plus®. This randomized controlled trial was carried out on 38 participants. Before intervention, ALL patients (n = 24) and healthy siblings (n = 14) had similar sleep quality in terms of polysomnography and Children's Sleep Habit Questionnaire findings. After intervention, total time asleep (p = 0.023), respiratory disturbance index of hypopnea (p = 0.005), apnea/hypopnea index (p = 0.008), and number of apnea (p = 0.028) statistically significant improved. Patients with ALL off treatment had similar values of sleep quality with healthy siblings. Novel types of exercises like VRBE have positive effects on sleep disorders in children with ALL and also healthy siblings. Future studies are needed comparing the different types of interventions.

Active Video Gaming Using an Adapted Gaming Mat in Youth and Adults With Physical Disabilities: Observational Study.

BackgroundA common leisure-time activity amongst youth and adults in the United States is video gameplay. Playing video games is typically a sedentary endeavor; however, to encourage an increased level of physical activity in an engaging and enjoyable way, active video gaming has become popular. Unfortunately, the accessibility of gaming controllers is often an issue for persons with disabilities. A commercial off-the-shelf (OTS) gaming mat was adapted to facilitate use by individuals with mobility impairments to address this issue.ObjectiveOur study aimed to examine energy expenditure, enjoyment, and gameplay experience in youth and adults with mobility impairment during active video gaming using an OTS and adapted versions of a gaming mat.MethodsThe study used an observational design. During visit 1, physical function was assessed, and participants were given a familiarization period with the gaming system. For visit 2, based on observation during the physical function tests and discussion with the participant, it was decided whether the participant would play in a standing or seated position. For standing gameplay, the mat was placed on the floor, and for seated play, the mat was placed on a height-adjustable and tilt-adjustable tabletop. Metabolic data were collected during a 20-minute baseline and four 10-minute bouts of Wii Fit Plus gameplay, with 2 bouts on each of the mats (adapted and OTS). During gameplay, the research staff observed and rated participants’ ability to use the game controller (mat) and the quality of gameplay. At the end of each game set, participants reported their rating of perceived exertion on a scale from 0 to 10. During rest, participants completed the physical activity enjoyment scale. Participants also answered additional questions regarding the system's usability with each controller (adapted mat and OTS mat). Statistical analyses were computed using Stata 16 (version 16.1; StataCorp). Linear mixed-effects maximum likelihood regression was performed separately for individuals who could play standing and for those who played seated.ResultsA convenience sample of 78 individuals with mobility impairments between the ages of 12 and 60 years (mean 39.6, SD 15.8) participated in the study. Of the sample, 48 participants played the video games in a seated position, while 30 played the games standing. Energy expenditure and heart rate tended to be higher in the OTS mat condition for seated players, while values were similar for both conditions among standing players. However, seated participants reported greater gameplay experience, and both groups exhibited a higher quality of gameplay during the adapted mat condition.ConclusionsActive video gaming using an adapted gaming mat provided an enjoyable exercise activity for individuals with mobility impairments. The use of the adapted controller provides a means by which this population can engage in light to moderate intensity active video gaming, thereby reducing sedentary leisure time.Trial RegistrationClinicalTrials.gov NCT02994199; https://clinicaltrials.gov/ct2/show/NCT02994199

Comparison of the effects of Wii and conventional training on functional abilities and neurocognitive function in basketball-players with functional ankle instability: Matched randomized clinical trial

Objective: To compare the effects of Wii and conventional training on functional abilities and neurocognitive function in basketball-players with Functional Ankle Instability (FAI). Design: Single-blind matched randomized clinical trial study. Setting: Outpatients setting. Participants: Fifty-four basketball-players were randomly assigned to the Wii and control group. Interventions: All athletes in the Wii group (n = 27) performed Wii Fit Plus games; and in the control group (n = 27), they performed conventional training three days a week for 12 sessions. Main outcome measures: To assess functional performance and neurocognitive function, we used hop tests (8-hop, side hop, and single hop) and Deary-Liewald Reaction Time Task (DLRT), respectively. DLRT measured simple and choice reaction time and error rate. Measures were taken at baseline, four weeks, and eight weeks after baseline. Results: In all 54 athletes completed the study. The results showed no significant differences for all hop tests in between-group comparison but the neurocognitive function showed significant improvements in the Wii group compared to the control group (P < 0.05). Mean (SD) for 8-hop and side hop tests for the involved limb, and simple and choice reaction time four weeks after baseline in the control group were 10.15 (1.02), 12.36 (1.31), and 339.10 (41.57), 530.52 (53.36), respectively and in the Wii group, were 10.46 (1.23), 12.40 (1.31), and 295.25 (13.16), 431.19 (33.46), respectively. Conclusion: Based on our results, both training protocols were equal to positively affect functional abilities. Besides, Wii training improved neurocognitive function and can be applied in FAI rehabilitation protocols.

Stationary walking performance of post-stroke patients and healthy individuals in real and virtual non-immersive environments

BACKGROUND: Several therapies are being used for the rehabilitation of stroke patients, such as Virtual Reality (VR) which has emerged as an interactive intervention to motivate and rehabilitate post-stroke patients. However, data comparison between the virtual and real environments is inconclusive. Thus, this study aimed to compare the kinematics and performance of the affected lower limb of post-stroke patients and healthy individuals during stationary walking activity between the real and virtual non-immersive environments. METHODS: A cross-sectional study was conducted with 10 stroke patients and 10 healthy individuals, matched for gender and age. The participants performed stationary walking in a real and non-immersive virtual environment (Wii Fit Plus® –Running mode) for 3 minutes in random order. The performance was measured in both environments using the number of steps, while the kinematics was assessed by calculating the mean maximum flexion and extension of each joint (hip, knee, and ankle) of the affected lower limb. RESULTS: Post-stroke patients performed a higher total number of steps (p = 0.042), mainly in the third minute (p = 0.011), less knee flexion (p = 0.001) and total knee range of motion (p = 0.001) in the virtual compared with the real environment. CONCLUSIONS: Post-stroke patients performed more steps, with a faster cadence and smaller knee range of motion on the affected side in non-immersive virtual environment compared with the real environment.

Evaluation of dual-task performance with Nintendo Wii-Fit plus in children with specific learning disabilities

Objective The aim of this study was to evaluate postural stability with Nintendo Wii-Fit Plus in children with special learning disabilities (SLD) and also to investigate the effect of simultaneous cognitive and motor tasks on postural stability. Methods The study included 70 children (35 children with SLD and 35 children age-matched normal development). All children were assessed for stability on Nintendo Wii-Fit Plus platform on one-leg stance (OLS). Postural stability percentages were calculated by asking for cognitive and motor tasks simultaneously with the task of standing on OLS. Results Children with SLD were found to have poor postural stability scores in comparison with children with normal development with Nintendo Wii-Fit Plus (p < .05). Compared to single task performance in both study and control groups; it was found that the addition of a motor task impaired postural stability, while it was observed that the addition of a cognitive task only affected postural stability in the control group (p < .05). Conclusion Postural stability in children with SLD was found to be worse than normal children. Although the addition of concurrent motor task with postural control disrupted postural stability in both normal and SLD children, it was determined that the effect of dual task was more significant in children with SLD. While the addition of cognitive task did not affect the postural stability of children with SLD, the postural stability of normal children was observed to be affected. While performing postural control evaluations of children with SLD, not only posture task but also cognitive and motor dual task performances should be evaluated.

Effect of Taping and Virtual Reality Combined Exercise on Static and Dynamic Balance With Functional Ankle Instability

Background: Ankle sprain is one of the most common musculoskeletal injuries in the sports population or during usual daily life activities. The sprain can cause functional ankle instability (FAI), and it is very important to treat FAI. However, the optimum intervention method for FAI has yet to be determined. Objects: This study investigated the impact that virtual reality (VR) training program on balance with ankle kinesio taping for FAI. Methods: Twenty-two people were selected for the study and randomly divided into the experimental (n = 11) and the control group (n = 11). The experimental group had attached kinesio taping on the ankle and then implemented a virtual reality exercise program for 30 minutes a day. Nintendo Wii Fit Plus was used for the VR intervention three times a week for four weeks. The control group performed only two measurements without intervention. Results: There were no statistically significant differences in overall, anterior-posterior (AP), medial-lateral (ML) index of the static balance, and significant differences in overall, AP, ML index of the dynamic balance when taping and VR exercise were applied at the same time (p < 0.05). There were no significant differences in overall and ML index of static and dynamic balance compared with before and after assessment between the experimental and the control group, and found differences in AP index of static and dynamic balance (p < 0.05). Conclusion: Kinesio taping may not influence the balance of FAI as great as people expected. VR approach does not affect the static balance of FAI, but it influences dynamic balance in overall, AP, ML index. The authors suggest that VR-based exercises can be used as an additional concept in clinicians for FAI or as part of a home program because the exercises still have limitations.

Comparison of Effects After Applying Virtual Reality Ankle Exercise and High-frequency Current to Functional Ankle Instability

The purpose of this study is to find an optimal rehabilitation therapy intervention, especially in this study, by comparing the effects of applying both virtual reality (VR) programs and microwave diathermy (MWD) at the same time. The subjects of this study participated 19 college students in their 20s. The subjects were randomly divided into two groups. The first group received MWD (male:2 female:8) and VR ankle training, while the second group (male:2 female:7) received only the VR training. The interventions were conducted three times a week for four weeks. Biodex Balance System® is a tool to measure balance degree in this study. The MWD (PM-800S, ITO, Japan) intervention was conducted by setting the frequency of 2450㎒ and the output of 100W before the implementation of the VR exercise program. The exercise in this study was conducted using the Nintendo Wii Fit Plus program for VR exercise. Comparison of the results of the groups that implemented MWD and VR at the same time and those that implemented VR only are as follows. In the static balance, VR groups were significantly lower in all directions such as overall, anterior-posterior, and medial-lateral (p .05). If the therapist does not properly perform the examination when applying MWD for FAI, the effect might not be significant. VR exercise programs can also be used to improve the balance of FAI, although it has limitations.

Effects of 4 Weeks of Active Exergames Training on Muscular Fitness in Elderly Women.

Gallardo-Meza, C, Simon, K, Bustamante-Ara, N, Ramirez-Campillo, R, García-Pinillos, F, Keogh, JWL, and Izquierdo, M. Effects of 4 weeks of active exergames training on muscular fitness in elderly women. J Strength Cond Res 36(2): 427-432, 2022-To analyze the effects of 4 weeks of an active exergames training program on muscular fitness in older women, 2 groups of community dwelling physically active subjects were formed by block-design randomization. One was deemed the control group (CG, n = 37; age 68.1 ± 3.3 years), and a second group completed 4 weeks of an active exergames training program (ExG, n = 35; age, 69.2 ± 3.7 years). Training included active exergames (Wii Fit Plus) performed on the Wii Balanceboard, 2 sessions per week. The exergames required mainly balance-related movements, such as leaning forward, leftward, and rightward, also requiring isometric squat positions and explosive leg extension. A supervisor-to-subject ratio method of 2:1 was used. An intensity-based individual progressive overload was applied. There were no significant (all p > 0.05, d = 0.01-0.07) baseline differences between-groups for all dependent variables. For the ExG, significant improvements were observed in static balance right leg test (Δ75.5%, d = 0.89), static balance left leg (Δ33.7%, d = 0.57), timed up-and-go test (Δ14.8%, d = 0.85) and sit-to-stand velocity test (Δ83.8%, d = 1.62). For the control group, trivial to small decrements in performance were observed across all tests (Δ -2.1 to -8.4%, d = -0.08 to 0.32). Group × time interactions were observed for the static balance right and left leg, timed up-and-go test, and the mean velocity achieved in the 5-repetition sit-to-stand test (all p < 0.001; d = 0.33-0.60). In conclusion, exergames training improves muscular fitness in older women. These results should be considered when designing appropriate and better exercise training programs for older women.

Game therapy a new approach to treat women facing mixed urinary incontinence: A study protocol.

To describe a pelvic floor muscle training (PFMT) isolated and associated with game therapy (PFMT + GT) for women facing mixed urinary incontinence (MUI) during climacteric period. To standardize a randomized controlled clinical trial intervention, a protocol was created, in an attempt to decrease women's symptomatology generated by MUI, through pelvic floor and abdomino-loin-pelvic muscles strength, and endurance. This study protocol will be composed of 32 volunteers, divided into two groups of 16. They will perform PFMT isolated or PFMT + GT, twice a week during 8 weeks. Interventions will last 40 minutes and will be divided into warming (5 minutes), training (30 minutes), and 5 minutes will be composed of resting time between exercises (1 minute each). Isolated PFMT sessions will be performed through four modalities of exercises: diaphragmatic, bridge, abdominal (plank), and pelvic mobility. PFMT + GT training will be carried out by using Wii Fit Plus games, such as Lotus Focus, Penguin Slide, Basic Step, and Hula Hoop from Wii equipment. Assessments will occur before, after, and 1 month after interventions. Vaginal manometry, 1-hour Pad Test, International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), and Patient Global Intervention (PGI) will be used to evaluate the sample. It is expected greater increase on pelvic floor muscle (PFM) strength, endurance, vaginal pressure for PFMT + GG. Moreover, it is supposed that PFMT + GT volunteers present better treatment adherence due to games motivational inclusion.

The Effects of Wii Fit Plus Training on Functional Ability in Athletes with Functional Ankle Instability

Summary Background Ankle sprain is a common sport injury that can lead to functional ankle instability. Virtual Reality Training such as Wii Fit Plus may improve functional deficit often associated with functional ankle instability. Material and Methods Fifty male basketball players with and without unilateral, functional ankle instability were assigned into two groups of experimental and control, respectively. All athletes had inclusion criteria to participate in the study. The experimental group performed Wii Fit Plus games including balance training and strengthening exercises three days a week for four weeks. The control group received no training. Before and after training, the functional ability of individuals was assessed by functional performance tests including the figure-of-8 hop, side hop, and single hop tests. Results Significant differences were observed in the figure-of-8 hop and side hop before and after training (p 0.05). Conclusion Based on our results, Wii as a neuromuscular training could be considered for individuals with functional ankle instability as a useful tool for improving the power and performances.

Interactive video game-based approaches improve mobility and mood in older adults: A nonrandomized, controlled tri̇al

Background and purposeRecently, technology-based approaches have become more frequently used in the field of rehabilitation. The aim of this study was to evaluate the effectiveness of interactive video games on mobility, general mood, and quality of life and compare them with physical activity approaches in older adults. MethodsNinety-one residents of a nursing home were assessed and 58 volunteers who met the criteria were included in the study. Participants in Group I (n = 16) participated in a 30-min exercise program using the “Nintendo Wii Fit Plus” twice a week for 8 weeks. Group II (n = 14) participated in a physical activity program consisting of a bicycle ergometer and treadmill for the same duration. Participants were assessed pre- and post-intervention for functional mobility, general depression, and quality of life.The "Wilcoxon Signed-Rank" test was used to compare the pre- and post-treatment outcomes. The Kruskal-Wallis analysis of variance (post hoc Tukey's HSD test) was used to evaluate differences between the groups. Resultsand Discussion: Post-intervention, the scores in the Berg Balance Scale increased significantly for GI and GII compared to the control group (p = 0.001, p = 0.002) Timed Up and Go Test improved for GI (p = 0.001) and 10-Meter Walk Test improved for GI (p = 0.003). Although there was a significant change in Hamilton depression score for GI and GII (p < 0.005), between-group differences were not significant. ConclusionsBoth programs demonstrated significant improvement in in all parameters. However, video-based program was more effective than physical activity, especially in mobility and balance parameters.

Evaluation of the exercise intensity generated by active video gaming in patients with cystic fibrosis and healthy individuals

BackgroundAdherence of patients with cystic fibrosis (CF) to exercise is challenging. Here we compared the physiological responses during the use of interactive video games (VG) with the cardiopulmonary exercise test (CPET) in healthy and CF subjects. MethodsCross-sectional study including CF and healthy (CON) subjects older than 6 years. Individuals were evaluated in two visits. At visit one, anthropometric measures, spirometry and CPET were performed. In the second visit, a physical activity questionnaire was applied and gas analyses performed during the use (10 min) of both Nintendo Wii (Wii Fit Plus: (1) Obstacle Course, (2) Rhythm Boxing and (3) Free Run) and Xbox One (Just Dance 2015: (1) Love Me Again, (2) Summer and (3) Happy). ResultsTwenty-five CON and 30 CF patients were included. The mean FEV1 (%) was significantly lower in the CF group compared to CON. There were no differences between groups at peak exercise (CPET) for heart rate (HR), oxygen consumption (VO2) and minute ventilation (VE). In the CON group, games 2 and 3 (Xbox) and game 3 (Nintendo) increased HR to values similar to the anaerobic threshold (AT), while for the CF group this occurred for games 2 (Xbox) and 3 (Nintendo). As for VO2 and VE, both groups obtained similar responses as compared to AT values in games 2 (Xbox) and 3 (Nintendo). ConclusionThe use of VG generated a cardiorespiratory response similar to AT levels found during CPET, indicating that it may be an alternative for exercise training of CF individuals.

Comparison Between the Effectiveness of Wii Fit Plus and Core Exercise Program in Improving Core Stability in Adults

Comparison Between the Effectiveness of Wii Fit Plus and Core Exercise Program in Improving Core Stability in Adults

Comparison of virtual reality exercise versus conventional exercise on balance in patients with functional ankle instability: A randomized controlled trial.

Recently, a variety of virtual reality (VR)-based interventions have been studied. However, they were only partially applied to physical therapy. The present study investigated the effects of a VR exercise program by comparing the results of VR and conventional exercise on balance in patients with functional ankle instability (FAI). Twenty-one participants with symptoms of FAI participated in this study. In the VR training program, the strength and balance exercises were done for 10 minutes each using a program included in the Nintendo Wii Fit Plus for VR intervention. In the conventional program, four ankle strength exercises using the TheraBand and the balance exercises were performed for 10minutes each. Static and dynamic balance were measured in the overall, anterior-posterior, and medial-lateral directions. Static balance in the VR exercise was significantly lower in the overall direction than in the conventional exercise. Dynamic balance in the virtual reality exercise was significantly lower than in the conventional exercise at level 2, level 4, and level 8 balance in the medial-lateral direction. This study has shown that VR exercise is more effective in the overall direction (static) and medial-lateral direction (dynamic) of balance than conventional method in patients with FAI.

Feasibility of a Home-Based Balance Intervention in Middle-Aged Women Using Wii Fit Plus®.

This study evaluated the feasibility and effectiveness of a home-based exercise intervention using the Wii Fit Plus®. A randomized, controlled trial of 24 women (age 53.6 [5.4]y) was used to assess compliance and changes in balance over 12 weeks. Balance was measured via the Berg Balance Scale and Frailty and Injuries: Cooperative Studies of Intervention Techniques-4 Scale at baseline and week 6 and week 12. Participant compliance to the intervention was captured via paper logs and the electronic record collected by the Wii Fit Plus®. Participants in the intervention group were 95% compliant based on electronic records. There were no significant differences between groups for total score on either balance scale. There was a significant group × time interaction in favor of the intervention for maximum velocity y (P < .05), average velocity (P < .05), and was trending for maximum velocity x (P = .05) in the tandem step, eyes closed position. The results suggest that the Wii Fit Plus® is appropriate for home-based interventions in middle-aged women. Modest improvements in balance indicate that this may be an effective means to improve or maintain balance in older women. More research is needed to determine compliance and benefits to reducing fall risk in durations exceeding 12 weeks.

Energy Expenditure and Enjoyment During Active Video Gaming Using an Adapted Wii Fit Balance Board in Adults with Physical Disabilities: Observational Study.

BackgroundIndividuals with physical disabilities have fewer opportunities to participate in enjoyable physical activity. One option for increasing physical activity is playing active video games (AVGs); however, many AVGs are inaccessible or offer limited play options.ObjectiveThis study aimed to examine energy expenditure and enjoyment in adults with mobility impairment during AVG play using off-the-shelf (OTS) and adapted versions of the Wii Fit balance board (Nintendo).MethodsDuring visit 1, participants completed a functional assessment and the familiarization period. During visit 2, metabolic data were collected during a 20-minute baseline and four 10-minute bouts of Wii Fit Plus game play, with two bouts on each of the boards. During the resting period, participants completed the Physical Activity Enjoyment Scale (PACES). Statistical analyses were computed using SPSS software. Data were analyzed separately for individuals who were able to play while standing on both boards (StdStd); those who could not play while standing on the OTS board, but were able to play while standing on the adapted board (aStd); and those who could only play while sitting on the adapted board (aSit).ResultsData were collected for 58 participants (StdStd, n=17; aStd, n=10; aSit, n=31). The sample included 31 men and 27 women with a mean age of 41.21 (SD 12.70) years. Energy expenditure (metabolic equivalent [MET]) during game play was significantly greater than that during rest for all players. Only 17 participants (StdStd group) were able to play using the OTS board. During game play on the adapted board, the average MET values for the two game sets were 2.261 (SD 0.718) kcal/kg/hour and 2.233 (SD 0.751) kcal/kg/hour for the aSit group, 3.151 (SD 1.034) and 2.990 (SD 1.121) for the aStd group, and 2.732 (SD 0.655) and 2.777 (SD 0.803) for the StdStd group. For game play on the adapted board, self-reported ratings of perceived exertion on a 0-10 scale suggested greater exercise intensity levels, with median scores ranging from moderate (3) to very hard (7). The PACES scores indicated that all players enjoyed using the adapted board, with a median score of 4 on a 5-point scale.ConclusionsThe adapted Wii Fit balance board provided an opportunity for individuals with mobility impairments, including wheelchair users, to engage in AVG. All participants were able to utilize the adapted controller and enjoyed the AVG activity. Although the average MET values achieved during AVG represented light-intensity exercise (<3 METs), 16% of sitting participants and 41% of standing participants achieved moderate-intensity exercise (3-6 METs) in at least one of the games. Factors not accounted for, which may have influenced the intensity of exercise, include game selection, limited familiarization period, and discomfort wearing the COSMED portable metabolic system for measurement of oxygen consumption. Accessible AVG controllers offer an innovative approach to overcome various barriers to participation in physical activity. The next steps include assessment of an AVG intervention using an adapted board gaming controller on health and fitness outcomes.Trial RegistrationClinicalTrials.gov NCT02994199; https://clinicaltrials.gov/ct2/show/NCT02994199 (Archived by Webcite at http://www.webcitation.org/75fc0mN39).

Efeitos da realidade virtual na função muscular em mulheres com incontinência urinária: relatos de caso

INTRODUÇÃO: A incontinência urinária (IU) é um dos mais constrangedores e estressantes sintomas urinários e a principal disfunção do assoalho pélvico. O tratamento através da realidade virtual tem o objetivo de aumentar a adesão das pacientes ao tratamento de forma lúdica e não invasiva, promovendo a capacidade de contração dos MAP durante as atividades físicas, com potenciais reflexos na melhora da incontinência. OBJETIVOS: Avaliar a função muscular do assoalho pélvico e perda de urina de mulheres incontinentes tratadas por meio de um protocolo específico de terapia por exposição à realidade virtual. MÉTODOS: Relato de casos, composto 02 casos de mulheres com diagnóstico médico de IU. Tratadas com realidade virtual através dos jogos do Nintendo Wii Fit PlusTM por 12 sessões de 50 minutos cada, três vezes por semana. Cada sessão compreendeu de 20 minutos de momento educativo, com orientações das ações durante os jogos e treinamento prévio para a contração dos músculos transverso do abdome e assoalho pélvico, seguido de 30 minutos de intervenção com o jogo. O protocolo foi dividido em duas fases de seis sessões cada de acordo com a dificuldade dos jogos, priorizando inicialmente aqueles que exploravam movimentos da pelve no plano frontal (Lotus FocusTM, Penguin SlideTM e Soccer HeadingTM) e, com a evolução, os que permitiam movimentos pélvicos mais globalizados (Penguin SlideTM, Table TiltTM e Balance BubbleTM). A função muscular do assoalho pélvico e a perda urinária foram avaliadas, respectivamente, através do Esquema PERFECT e do pad test de 1 hora, sendo os resultados sumarizados de forma descritiva em tabelas do Excel. RESULTADOS: Melhora da perda urinária através do pad test de 1 hora e da função muscular através da palpação digital associada ao Esquema PERFECT das participantes com incontinência urinária após intervenção. CONCLUSÃO: O tratamento dos MAP através da realidade virtual demonstrou-se efetivo na melhora da perda urinária e da função muscular do assoalho pélvico nas participantes deste estudo, porém fazem-se necessárias ensaios clínicos para comprovar sua eficácia.