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Tacchino A, Ponzio M, Confalonieri P, Leocani L, Inglese M, Centonze D, Cocco E, Gallo P, Paolicelli D, Rovaris M, Sabattini L, Tedeschi G, Prosperini L, Patti F, Bramanti P, Pedrazzoli E, Battaglia MA, Brichetto G. An Internet- and Kinect-Based Multiple Sclerosis Fitness Intervention Training With Pilates Exercises: Development and Usability Study. JMIR Serious Games 2023; 11:e41371. [PMID: 37938895 PMCID: PMC10666018 DOI: 10.2196/41371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 01/30/2023] [Accepted: 07/30/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Balance impairments are common in people with multiple sclerosis (MS), with reduced ability to maintain position and delayed responses to postural adjustments. Pilates is a popular alternative method for balance training that may reduce the rapid worsening of symptoms and the increased risk of secondary conditions (eg, depression) that are frequently associated with physical inactivity. OBJECTIVE In this paper, we aimed to describe the design, development, and usability testing of MS Fitness Intervention Training (MS-FIT), a Kinect-based tool implementing Pilates exercises customized for MS. METHODS MS-FIT has been developed using a user-centered design approach (design, prototype, user feedback, and analysis) to gain the target user's perspective. A team composed of 1 physical therapist, 2 game programmers, and 1 game designer developed the first version of MS-FIT that integrated the knowledge and experience of the team with MS literature findings related to Pilates exercises and balance interventions based on exergames. MS-FIT, developed by using the Unity 3D (Unity Technologies) game engine software with Kinect Sensor V2 for Windows, implements exercises for breathing, posture, and balance. Feedback from an Italian panel of experts in MS rehabilitation (neurologists, physiatrists, physical therapists, 1 statistician, and 1 bioengineer) and people with MS was collected to customize the tool for use in MS. The context of MS-FIT is traveling around the world to visit some of the most important cities to learn the aspects of their culture through pictures and stories. At each stay of the travel, the avatar of a Pilates teacher shows the user the exercises to be performed. Overall, 9 people with MS (n=4, 44% women; mean age 42.89, SD 11.97 years; mean disease duration 10.19, SD 9.18 years; Expanded Disability Status Scale score 3.17, SD 0.75) were involved in 3 outpatient user test sessions of 30 minutes; MS-FIT's usability was assessed through an ad hoc questionnaire (maximum value=5; higher the score, higher the usability) evaluating easiness to use, playability, enjoyment, satisfaction, and acceptance. RESULTS A user-centered design approach was used to develop an accessible and challenging tool for balance training. All people with MS (9/9, 100%) completed the user test sessions and answered the ad hoc questionnaire. The average score on each item ranged from 3.78 (SD 0.67) to 4.33 (SD 1.00), which indicated a high usability level. The feedback and suggestions provided by 64% (9/14) of people with MS and 36% (5/14) of therapists involved in the user test were implemented to refine the first prototype to release MS-FIT 2.0. CONCLUSIONS The participants reported that MS-FIT was a usable tool. It is a promising system for enhancing the motivation and engagement of people with MS in performing exercise with the aim of improving their physical status.
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Affiliation(s)
- Andrea Tacchino
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy
| | - Michela Ponzio
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy
| | - Paolo Confalonieri
- Multiple Sclerosis Center, IRCCS Foundation "Carlo Besta" Neurological Institute, Milan, Italy
| | - Letizia Leocani
- Vita-Salute University & Hospital San Raffaele, Milan, Italy
| | - Matilde Inglese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- IRCCS San Martino Hospital, Genoa, Italy
| | | | - Eleonora Cocco
- Department of Medical Science and Public health, University of Cagliari, Cagliari, Italy
| | - Paolo Gallo
- Department of Neuroscience, University of Padua, Padua, Italy
| | - Damiano Paolicelli
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Marco Rovaris
- Multiple Sclerosis Center, IRCCS Don Carlo Gnocchi Foundation, Milan, Italy
| | - Loredana Sabattini
- Uosi Multiple Sclerosis Rehabilitation, IRCCS Istituto delle Scienze Neurologiche of Bologna, Bologna, Italy
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Luca Prosperini
- Department of Neurosciences, S. Camillo-Forlanini Hospital, Rome, Italy
| | - Francesco Patti
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | | | | | | | - Giampaolo Brichetto
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy
- Rehabilitation Service of Genoa, Italian Multiple Sclerosis Society, Genoa, Italy
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Chen X, Wu L, Feng H, Ning H, Wu S, Hu M, Jiang D, Chen Y, Jiang Y, Liu X. Comparison of Exergames Versus Conventional Exercises on the Health Benefits of Older Adults: Systematic Review With Meta-Analysis of Randomized Controlled Trials. JMIR Serious Games 2023; 11:e42374. [PMID: 37347534 PMCID: PMC10337432 DOI: 10.2196/42374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 02/08/2023] [Accepted: 05/13/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Conventional exercises (CEs) can provide health benefits for older adults, but the long-term exercise adherence rate is low. As an emerging, stimulating, and self-motivating strategy, exergames (EGs) are defined as combinations of exercises and games that users carry out through physical actions. They can promote exercise, but the health effects of EGs versus CEs on the physical function and mental health (cognitive function, depression, and quality of life) of older adults remain controversial. OBJECTIVE The aim of the study is to compare the health benefits of EGs versus those of CEs for the physical function and mental health of older adults. METHODS A comprehensive search was conducted from the earliest available date to February 2023 in the following 6 databases: PubMed, Web of Science, Embase, Cochrane, CINAHL, and PsycINFO. All English-language randomized controlled trials comparing the effects of EGs versus those of CEs on the physical function and mental health of older adults, with nearly same physical activity between the 2 interventions, were included. Risk of bias was independently evaluated by 2 authors using the Cochrane risk of bias in randomized trials tool. Two authors independently extracted data. We followed the Cochrane Handbook of Systematic Reviews of Interventions to process and analyze the data for meta-analysis. Standardized mean differences (SMDs) and 95% CIs were used for continuous data, and random models were used for analyses. RESULTS We included 12 studies consisting of 919 participants in total. Of these, 10 studies were eventually included in the meta-analysis. The results showed that EGs versus CEs exhibited no significant differences in physical (P=.13; τ2=0.31; χ26=26.6; I2=77%; SMD=0.37; 95% CI -0.11 to 0.86) or cognitive function (P=.63; τ2=0.01; χ23=3.1; I2=4%; SMD=0.09; 95% CI -0.27 to 0.44) effects. CONCLUSIONS Our findings indicate no significant difference between EGs and CEs in improving the physical function and cognitive function of older adults. Future studies are required to compare the effects of EGs versus those of CEs on cognitive function according to cognitive status, quantify the "dose-effect" relationship between EGs and health benefits, and evaluate the effects of different types and devices of EGs with regard to the health benefits of older adults. TRIAL REGISTRATION PROSPERO CRD42022322734; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=322734.
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Affiliation(s)
- Xi Chen
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Lina Wu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Hui Feng
- Xiangya School of Nursing, Central South University, Changsha, China
- Xiangya-Oceanwide Health Management Research Institute, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Hongting Ning
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Shuang Wu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Mingyue Hu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Dian Jiang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yifei Chen
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yu Jiang
- Changsha Xingsha Hospital, Changsha, China
| | - Xin Liu
- Department of General Practice, 921 Hospital of Joint Logistics Support Force, The Chinese People's Liberation Army, Changsha, China
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Jansson MM, Koivisto J. Effectiveness of Game-Based Solutions in Patients with Total Hip and Knee Arthroplasty: A Systematic Review of Randomized Controlled Trials. Games Health J 2023; 12:25-33. [PMID: 36579917 DOI: 10.1089/g4h.2022.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The aim of this systematic review of randomized controlled trials (RCTs) was to evaluate the effectiveness of game-based solutions in patients with total knee arthroplasty or total hip arthroplasty. The systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies published prior May 2022 were identified from MEDLINE Ovid, Scopus, EBSCO Databases, Web of Science, and PubMed. The Joanna Briggs Institute Critical Appraisal Checklist for RCTs was used to evaluate the quality of the relevant studies published. A narrative synthesis was used to report the results while effect sizes were estimated for different outcomes. A total of 350 records were identified, and 5 RCTs were selected. Most of the game-based solutions were exergames to support rehabilitation. The findings indicate that game-based solutions have potential to induce positive impact on functional and cognitive performance; however, due to the low number of studies and moderate/weak quality of existing research, the area still lacks assertive evidence. Future research should pay attention to the methodological aspects to provide reliable information on the use of game-based solutions in the given context.
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Affiliation(s)
- Miia M Jansson
- Research Group of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Jonna Koivisto
- Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland
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Ebrahimi N, Rojhani-Shirazi Z, Yoosefinejad AK, Nami M. The effects of virtual reality training on clinical indices and brain mapping of women with patellofemoral pain: a randomized clinical trial. BMC Musculoskelet Disord 2021; 22:900. [PMID: 34696764 PMCID: PMC8544183 DOI: 10.1186/s12891-021-04785-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 10/08/2021] [Indexed: 11/10/2022] Open
Abstract
Background Virtual reality training (VRT) is a new method for the rehabilitation of musculoskeletal impairments. However, the clinical and central effects of VRT have not been investigated in patients with patellofemoral pain (PFP). To comprehensively assess the effects of VRT on clinical indices and brain function, we used a randomized clinical trial based on clinical and brain mapping assessment. Methods Twenty-six women with PFP for more than 6 months were randomly allocated to 2 groups: intervention and control. The intervention consisted of lifestyle education + 8 weeks VRT, in 24 sessions each lasting 40 min of training, whereas the control group just received lifestyle education. The balance was the primary outcome and was measured by the modified star excursion balance test. Secondary outcomes included pain, function, quality of life, and brain function which were assessed by visual analogue scale, step down test and Kujala questionnaire, SF-36, and EEG, respectively. Pre-intervention, post-intervention and follow-up (1 month after the end of the intervention) measurements were taken for all outcome measures except EEG, which was evaluated only at pre-intervention and post-intervention). Analyses of variance was used to compare the clinical outcomes between the two groups. The independent t-test also was used for between group EEG analyses. Results Balance score (P < 0.001), function (P < 0.001), and quality of life (P = 0.001) improved significantly at post-intervention and 1 month follow-up in the VRT group compared with the control group. VRT group showed a significantly decreased pain score (P = 0.004). Alpha (P < 0.05) and theta (P = 0.01) power activity also increased in the brain of the VRT group. Conclusion This study demonstrated that long term VRT was capable of improving both clinical impairments and brain function in patients with PFP. Therefore, therapists and clinicians can use this method as a more holistic approach in the rehabilitation of PFP. Trial registration IRCT, IRCT20090831002391N40. Registered 23 / 10 / 2019.
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Affiliation(s)
- Naghmeh Ebrahimi
- Student Research Committee, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Chamran Blvd., Abiverdi 1Street, P.O. Box: 71345-1733, Shiraz, Iran
| | - Zahra Rojhani-Shirazi
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Chamran Blvd., Abiverdi 1Street, P.O. Box: 71345-1733, Shiraz, Iran.,Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amin Kordi Yoosefinejad
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Chamran Blvd., Abiverdi 1Street, P.O. Box: 71345-1733, Shiraz, Iran. .,Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohammad Nami
- Neuroscience Center, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), City of Knowledge, Panama City, 084301103, Panama.,Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, 71348-14336, Iran.,Dana Brain Health Institute, Iranian Neuroscience Society-Fars Chapter, Shiraz, 71364-76172, Iran.,Academy of Health, Senses Cultural Foundation, Sacramento, CA, 66006, USA.,Department of Cognitive Neuroscience, Institute for Cognitive Science Studies (ICSS), Pardis, Tehran, 1658344575, Iran
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Gjærde LK, Hybschmann J, Dybdal D, Topperzer MK, Schrøder MA, Gibson JL, Ramchandani P, Ginsberg EI, Ottesen B, Frandsen TL, Sørensen JL. Play interventions for paediatric patients in hospital: a scoping review. BMJ Open 2021; 11:e051957. [PMID: 34312210 PMCID: PMC8314749 DOI: 10.1136/bmjopen-2021-051957] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Play is a non-invasive, safe and inexpensive intervention that can help paediatric patients and their families manage difficult aspects of being ill or hospitalised. Although play has existed in hospitals for decades, research on hospital play interventions is scarce. This review aimed to categorise and synthesise the last 20 years of research on hospital play interventions. DESIGN Scoping review. DATA SOURCES PubMed, CINAHL, CENTRAL, ERIC and PsycINFO (1 January 2000- 9 September 2020). STUDY SELECTION AND DATA EXTRACTION We systematically searched for original peer-reviewed articles, written in English, on hospital play interventions in paediatric patients (0-18 years) in non-psychiatric settings. Two reviewers independently screened titles and abstracts, reviewed full text of relevant articles and extracted data. We thematically synthesised the data from the included studies, and a descriptive analysis, based on a developed framework, is presented. RESULTS Of the 297 included articles, 78% came from high-income countries and 56% were published within the last 5 years. Play interventions were carried out across all ages by various healthcare professionals. Play interventions served different roles within four clinical contexts: A) procedures and diagnostic tests, B) patient education, C) treatment and recovery and D) adaptation. Across these contexts, play interventions were generally facilitated and purpose-oriented and had positive reported effects on pain, stress, and anxiety. CONCLUSIONS Play in hospitals is an emerging interdisciplinary research area with a significant potential benefit for child and family health. Future research should further describe principles for play in hospitals. High-quality studies investigating short-term and long-term effects are needed to guide when and how to best integrate play in hospitals.
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Affiliation(s)
- Line Klingen Gjærde
- Children's Hospital Copenhagen and Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark
| | - Jane Hybschmann
- Children's Hospital Copenhagen and Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark
| | - Daniel Dybdal
- Children's Hospital Copenhagen and Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark
| | - Martha Krogh Topperzer
- Children's Hospital Copenhagen and Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark
| | - Morten Arnborg Schrøder
- Children's Hospital Copenhagen and Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark
| | - Jenny Louise Gibson
- Centre for Research on Play in Education, Development & Learning, Faculty of Education, Cambridge University, Cambridge, UK
| | - Paul Ramchandani
- Centre for Research on Play in Education, Development & Learning, Faculty of Education, Cambridge University, Cambridge, UK
| | - Elisabeth Ida Ginsberg
- Children's Hospital Copenhagen and Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark
| | - Bent Ottesen
- Children's Hospital Copenhagen and Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Leth Frandsen
- Children's Hospital Copenhagen and Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark
| | - Jette Led Sørensen
- Children's Hospital Copenhagen and Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Abstract
Home-based teleworking, associated with sedentary behavior, may impair self-reported adult health status. Current exercise recommendations, based on universal recipes, may be insufficient or even misleading to promote healthy teleworking. From the Network Physiology of Exercise perspective, health is redefined as an adaptive emergent state, product of dynamic interactions among multiple levels (from genetic to social) that cannot be reduced to a few dimensions. Under such a perspective, fitness development is focused on enhancing the individual functional diversity potential, which is better achieved through varied and personalized exercise proposals. This paper discusses some myths related to ideal or unique recommendations, like the ideal exercise or posture, and the contribution of recent computer technologies and applications for prescribing exercise and assessing fitness. Highlighting the need for creating personalized working environments and strengthening the active contribution of users in the process, new recommendations related to teleworking posture, home exercise counselling, exercise monitoring and to the roles of healthcare and exercise professionals are proposed. Instead of exercise prescribers, professionals act as co-designers that help users to learn, co-adapt and adequately contextualize exercise in order to promote their somatic awareness, job satisfaction, productivity, work–life balance, wellbeing and health.
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Cugusi L, Prosperini L, Mura G. Exergaming for Quality of Life in Persons Living with Chronic Diseases: A Systematic Review and Meta-analysis. PM R 2020; 13:756-780. [PMID: 32592238 DOI: 10.1002/pmrj.12444] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 06/11/2020] [Accepted: 06/19/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate the evidence of effectiveness of exergame-based rehabilitative interventions on health-related quality of life (HRQoL) in persons with chronic diseases. TYPE: Systematic review and meta-analysis. LITERATURE SURVEY Randomized and nonrandomized controlled trials of exergame rehabilitation interventions in populations with chronic diseases reporting HRQoL outcomes were identified by searching PubMed, Scopus, Physiotherapy Evidence Database (PEDro), Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar, using keywords and MeSH terms for papers published between January 2005 and March 2019. METHODOLOGY Risk of bias was assessed by using the PEDro scale. The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) system was used to score the quality of evidence. Pooled effects were reported as standardized mean differences (SMDs) or weighted mean difference (MDs) and 95% confidence intervals (CIs), using a random-effects model. Heterogeneity was weighted by inconsistency I2 tests. SYNTHESIS Thirty-four trials were identified (1594 participants). Overall, the evidence was low quality. Exergames significantly improved HRQoL in populations with chronic diseases, with a small effect size (32 studies; 1544 participants; SMD 0.24; 95% CI 0.1 to 0.4; I2 = 27%) and specifically in people with neurological disorders (20 studies, 956 participants, SMD 0.22; 95% CI 0.2 to 0.4; I2 = 49%), rheumatologic diseases (four studies, 210 participants, SMD 0.39; 95% CI 0.1 to 0.7; I2 = 4%), and cardiorespiratory and chronic metabolic conditions (five studies, 309 participants, SMD 0.23; 95% CI 0.0 to 0.5; I2 = 0%). Exergaming interventions in health care settings demonstrated similarly small but positive effects (22 studies, 905 participants, SMD 0.30; 95% CI 0.1 to 0.5; I2 = 41%), whereas those carried out in home-based contexts did not. CONCLUSIONS Exergame-based rehabilitative interventions performed in health care settings led to small but statistically significant improvements in HRQoL in persons with chronic diseases.
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Affiliation(s)
- Lucia Cugusi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Luca Prosperini
- Department of Neurosciences, San Camillo-Forlanini Hospital, Rome, Italy
| | - Gioia Mura
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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Hulaj R, Nyström MBT, Sörman DE, Backlund C, Röhlcke S, Jonsson B. A Motivational Model Explaining Performance in Video Games. Front Psychol 2020; 11:1510. [PMID: 32760321 PMCID: PMC7372929 DOI: 10.3389/fpsyg.2020.01510] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 06/05/2020] [Indexed: 11/17/2022] Open
Abstract
Esports are a rapidly growing phenomenon and understanding of factors underlying game performance are therefore of great interest. The present study investigated the influence of satisfaction of basic psychological needs (competence, autonomy, and relatedness), type of motivation (amotivation, external regulation, introjected regulation, identified regulation, integrated regulation, and intrinsic motivation), and number of matches played (time on task) on individuals’ performance on a matchmaking rating (MMR) in the video game Defence of the Ancients 2 (Dota 2). Collected data from 315 participants was included in the analyses. A web-based questionnaire was used to collect data and structural equation modelling (SEM) was performed to analyze the data. The results show that perceived competence and autonomy were the only significant predictors of MMR performance beyond matches played. Fulfillment of relatedness, as well as motivational factors, were not found to be predictors of MMR scores. The strong effect of matches played, used as proxy of time on task, emphasize the effect of time and practice as a critical aspect of video-game expertise.
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Affiliation(s)
- Rame Hulaj
- Department of Psychology, Umeå University, Umeå, Sweden
| | | | - Daniel E Sörman
- Department of Human Work Science, Luleå University of Technology, Luleå, Sweden
| | - Christian Backlund
- Department of Human Work Science, Luleå University of Technology, Luleå, Sweden
| | | | - Bert Jonsson
- Department of Applied Educational Science, Umeå University, Umeå, Sweden
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Dermody G, Whitehead L, Wilson G, Glass C. The Role of Virtual Reality in Improving Health Outcomes for Community-Dwelling Older Adults: Systematic Review. J Med Internet Res 2020; 22:e17331. [PMID: 32478662 PMCID: PMC7296414 DOI: 10.2196/17331] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/05/2020] [Accepted: 04/10/2020] [Indexed: 01/27/2023] Open
Abstract
Background Virtual reality (VR) delivered through immersive headsets creates an opportunity to deliver interventions to improve physical, mental, and psychosocial health outcomes. VR app studies with older adults have primarily focused on rehabilitation and physical function including gait, balance, fall prevention, pain management, and cognition. Several systematic reviews have previously been conducted, but much of the extant literature is focused on rehabilitation or other institutional settings, and little is known about the effectiveness of VR apps using immersive headsets to target health outcomes among community-dwelling older adults. Objective The objective of this review was to evaluate the effectiveness of VR apps delivered using commercially available immersive headsets to improve physical, mental, or psychosocial health outcomes in community-dwelling older adults. Methods Peer-reviewed publications that included community-dwelling older adults aged ≥60 years residing in residential aged care settings and nursing homes were included. This systematic review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness evidence. The title of this review was registered with JBI, and the systematic review protocol was registered with the International Prospective Register of Systematic Reviews. Results In total, 7 studies that specifically included community-dwelling older adults were included in this review. VR apps using a head-mounted display led to improvements in a number of health outcomes, including pain management, posture, cognitive functioning specifically related to Alzheimer disease, and a decreased risk of falls. A total of 6 studies reported a statistically significant difference post VR intervention, and 1 study reported an improvement in cognitive function to reduce navigational errors. Only one study reported on the usability and acceptability of the interventions delivered through VR. While one study used a distraction mechanism for pain management, none of the studies used gaming technology to promote enjoyment. Conclusions Interventions to improve health outcomes through VR have demonstrated potential; however, the ability to synthesize findings by primary outcome for the older adult population is not possible. A number of factors, especially related to frailty, usability, and acceptability, also need to be explored before more substantial recommendations on the effectiveness of VR interventions for older adults can be made. Trial Registration PROSPERO CRD42019143504; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=143504
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Affiliation(s)
- Gordana Dermody
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia
| | - Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia
| | | | - Courtney Glass
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia
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Exergames for balance dysfunction in neurological disability: a meta-analysis with meta-regression. J Neurol 2020; 268:3223-3237. [PMID: 32447551 DOI: 10.1007/s00415-020-09918-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate systematically the efficacy of exergames for balance dysfunction in neurological conditions and to identify factors of exergaming protocols that may influence their effects. METHODS We searched electronic databases for randomized clinical trials investigating the effect of commercial exergames versus alternative interventions on balance dysfunction as assessed by standard clinical scales in adults with acquired neurological disabilities. Standardized mean differences (Hedge's g) were calculated with random-effects models. Subgroup analyses and meta-regression were run to explore potential modifiers of effect size. RESULTS Out of 106 screened articles, 41 fulfilled criteria for meta-analysis, with a total of 1223 patients included. Diseases under investigation were stroke, Parkinson's disease, multiple sclerosis, mild cognitive impairment or early Alzheimer's disease, traumatic brain injury, and myelopathy. The pooled effect size of exergames on balance was moderate (g = 0.43, p < 0.001), with higher frequency (number of sessions per week) associated with larger effect (β = 0.24, p = 0.01). There was no effect mediated by the overall duration of the intervention and intensity of a single session. The beneficial effect of exergames could be maintained for at least 4 weeks after discontinuation, but their retention effect was specifically explored in only 11 studies, thus requiring future investigation. Mild to moderate adverse events were reported in a minority of studies. We estimated a low risk of bias, mainly attributable to the lack of double-blindness and not reporting intention-to-treat analysis. CONCLUSIONS The pooled evidence suggests that exergames improve balance dysfunction and are safe in several neurological conditions. The findings of high-frequency interventions associated with larger effect size, together with a possible sustained effect of exergaming, may guide treatment decisions and inform future research.
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Ogawa E, Huang H, Yu LF, You T. Physiological responses and enjoyment of Kinect-based exergames in older adults at risk for falls: A feasibility study. Technol Health Care 2019; 27:353-362. [PMID: 31033470 DOI: 10.3233/thc-191634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Exergaming has the potential to improve physical function, cognition and dual-task function, and could be an effective new strategy for reducing risk of falling in older adults. OBJECTIVE To evaluate and test custom Microsoft Kinect-based motion-tracking exergames in older adults at risk for falls. METHODS Community-dwelling older adults who reported mobility difficulties or had fallen in the past year played three newly developed exergames (Target Trackers, Double Decision, and Visual Sweeps, 5 minutes each) in random order. Heart rate (HR) was measured during, and blood pressures (BPs), rating of perceived exertion (RPE), and rating of the enjoyment were recorded immediately after each exergame. RESULTS Seven participants (median age 75 y; 4 females) completed the study. There were no adverse events reported during the exergaming session. Exercise HRs and RPEs were statistically significantly higher than resting for all exergames (p< 0.05). The differences were not significant for BPs. Enjoyment ratings ranged from 79.6-90.6% and there were no statistically significant differences between the exergames. CONCLUSIONS The newly developed exergames were light in exercise intensity and enjoyable for older adults at risk for falls. Future intervention studies are warranted to examine the benefits of exergames for this special population.
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Affiliation(s)
- Elisa Ogawa
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA
| | - Haikun Huang
- Department of Computer Science, College of Science and Mathematics, University of Massachusetts Boston, Boston, MA 02125, USA
| | - Lap-Fai Yu
- Department of Computer Science, College of Science and Mathematics, University of Massachusetts Boston, Boston, MA 02125, USA
| | - Tongjian You
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA
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12
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Simmich J, Deacon AJ, Russell TG. Active Video Games for Rehabilitation in Respiratory Conditions: Systematic Review and Meta-Analysis. JMIR Serious Games 2019; 7:e10116. [PMID: 30801256 PMCID: PMC6409512 DOI: 10.2196/10116] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 06/11/2018] [Accepted: 07/12/2018] [Indexed: 12/13/2022] Open
Abstract
Background Exercise and physical activity are key components of treatment for chronic respiratory diseases. However, the level of physical activity and adherence to exercise programs are low in people with these diseases. Active video games (AVGs) may provide a more engaging alternative to traditional forms of exercise. Objective This review examines the effectiveness of game-based interventions on physiological outcome measures, as well as adherence and enjoyment in subjects with chronic respiratory diseases. Methods A systematic search of the literature was conducted, with full texts and abstracts included where they involved an AVG intervention for participants diagnosed with respiratory conditions. A narrative synthesis of included studies was performed. Additionally, meta-analysis comparing AVGs with traditional exercise was undertaken for 4 outcome measures: mean heart rate (HR) during exercise, peripheral blood oxygen saturation (SpO2) during exercise, dyspnea induced by the exercise, and enjoyment of the exercise. Results A total of 13 full-text papers corresponding to 12 studies were included in the review. Interventions predominantly used games released for the Nintendo Wii (8 studies) and Microsoft Xbox Kinect (3 studies). There were 5 studies that examined the acute effects of a single session of AVGs and 7 studies that examined the long-term effects after multiple sessions of AVGs. Trials conducted over more than 1 session varied in duration between 3 and 12 weeks. In these, AVG interventions were associated with either similar or slightly greater improvements in outcomes such as exercise capacity when compared with a traditional exercise control, and they also generally demonstrated improvements over baseline or nonintervention comparators. There were a few studies of unsupervised AVG interventions, but the reported adherence was high and maintained throughout the intervention period. Additionally, AVGs were generally reported to be well liked and considered feasible by participants. For outcome measures measured during a single exercise session, there was no significant difference between an AVG and traditional exercise for HR (mean difference 1.44 beats per minute, 95% CI –14.31 to 17.18), SpO2 (mean difference 1.12 percentage points, 95% CI –1.91 to 4.16), and dyspnea (mean difference 0.43 Borg units, 95% CI –0.79 to 1.66), but AVGs were significantly more enjoyable than traditional exercise (Hedges g standardized mean difference 1.36, 95% CI 0.04-2.68). Conclusions This review provides evidence that AVG interventions, undertaken for several weeks, can provide similar or greater improvements in exercise capacity and other outcomes as traditional exercise. Within a single session of cardiovascular exercise, an AVG can evoke similar physiological responses as traditional exercise modalities but is more enjoyable to subjects with chronic respiratory diseases. However, there is very limited evidence for adherence and effectiveness in long-term unsupervised trials, which should be the focus of future research.
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Affiliation(s)
- Joshua Simmich
- Centre for Research Excellence in Telehealth, University of Queensland, Brisbane, Australia.,School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Anthony J Deacon
- Centre for Research Excellence in Telehealth, University of Queensland, Brisbane, Australia.,School of Electrical Engineering and Computer Science, Queensland University of Technology, Brisbane, Australia
| | - Trevor G Russell
- Centre for Research Excellence in Telehealth, University of Queensland, Brisbane, Australia.,School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
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Imam B, Miller WC, Finlayson HC, Eng JJ, Jarus T. A clinical survey about commercial games in lower limb prosthetic rehabilitation. Prosthet Orthot Int 2018; 42:311-317. [PMID: 29126375 DOI: 10.1177/0309364617740238] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Despite the popularity of commercial games in lower limb prosthetic rehabilitation, data about their prevalence of use as well as therapists' perspectives about these games are still lacking. OBJECTIVES To learn about the prevalence of use of commercial games in lower limb prosthetic rehabilitation and therapists' perspectives about these games. STUDY DESIGN Cross-sectional. METHODS An online survey was sent to physical and occupational therapists across prosthetic rehabilitation facilities in Canada. The survey had questions about the use of commercial games and therapists' perspectives. RESULTS Data were collected from 82 therapists. Overall, 46.3% (38/82) reported that they use commercial games; of those, 94.7% (36/38) used the Nintendo Wii Fit. The most reported perceived benefits were the Wii Fit helping to improve weight shifting ( n = 76/82, 92.7%) and balance ( n = 75/82, 91.5%), and being motivating and complementing traditional therapy ( n = 75/82, 91.5%). The most reported perceived barriers/challenges were lack of time and familiarity with the games ( n = 58/82, 70.7%). CONCLUSION Commercial games, particularly the Wii Fit, are commonly used in lower prosthetic rehabilitation in Canada. Most of the queried therapists view the Wii Fit positively. Knowledge translation activities and developing standard treatment protocols would be helpful in minimizing the barriers identified in this study. Clinical relevance The Wii Fit is prevalent in lower limb prosthetic rehabilitation in Canada and it is viewed positively by therapists as having the potential to improve balance and weight bearing, making rehabilitation more motivating, and complementing traditional therapy. Future studies should investigate the efficacy of the Wii Fit in prosthetic rehabilitation.
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Affiliation(s)
- Bita Imam
- The University of British Columbia, Vancouver, BC, Canada
| | | | | | - Janice J Eng
- The University of British Columbia, Vancouver, BC, Canada
| | - Tal Jarus
- The University of British Columbia, Vancouver, BC, Canada
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14
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Warland A, Paraskevopoulos I, Tsekleves E, Ryan J, Nowicky A, Griscti J, Levings H, Kilbride C. The feasibility, acceptability and preliminary efficacy of a low-cost, virtual-reality based, upper-limb stroke rehabilitation device: a mixed methods study. Disabil Rehabil 2018; 41:2119-2134. [DOI: 10.1080/09638288.2018.1459881] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Alyson Warland
- Department of Health Sciences and Social Care, Brunel University London, Uxbridge, UK
| | | | | | - Jennifer Ryan
- Department of Health Sciences and Social Care, Brunel University London, Uxbridge, UK
| | - Alexander Nowicky
- Department of Health Sciences and Social Care, Brunel University London, Uxbridge, UK
| | - Josephine Griscti
- Department of Health Sciences and Social Care, Brunel University London, Uxbridge, UK
| | - Hannah Levings
- Department of Health Sciences and Social Care, Brunel University London, Uxbridge, UK
| | - Cherry Kilbride
- Department of Health Sciences and Social Care, Brunel University London, Uxbridge, UK
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15
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Thomas S, Fazakarley L, Thomas PW, Collyer S, Brenton S, Perring S, Scott R, Thomas F, Thomas C, Jones K, Hickson J, Hillier C. Mii-vitaliSe: a pilot randomised controlled trial of a home gaming system (Nintendo Wii) to increase activity levels, vitality and well-being in people with multiple sclerosis. BMJ Open 2017; 7:e016966. [PMID: 28954791 PMCID: PMC5623500 DOI: 10.1136/bmjopen-2017-016966] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES While the health and well-being benefits of physical activity are recognised, people with multiple sclerosis (MS) often face greater barriers than the general population. The Nintendo Wii potentially offers a fun, convenient way of overcoming some of these. The aim was to test the feasibility of conducting a definitive trial of the effectiveness and cost-effectiveness of Mii-vitaliSe; a home-based, physiotherapist-supported Nintendo Wii intervention. DESIGN A single-centre wait-list randomised controlled study. SETTING MS service in secondary care. PARTICIPANTS Ambulatory, relatively inactive people with clinically confirmed MS. INTERVENTION Thirty participants were randomised to receive Mii-vitaliSe either immediately (for 12 months) or after a 6-month wait (for 6 months). Mii-vitaliSe consisted of two supervised Nintendo Wii familiarisation sessions in the hospital followed by home use (Wii Sports, Sports Resort and Fit Plus software) with physiotherapist support and personalised resources. OUTCOMES Included self-reported physical activity levels, quality of life, mood, self-efficacy, fatigue and assessments of balance, gait, mobility and hand dexterity at baseline, 6 and 12 months. Interviews (n=25) explored participants' experiences and, at study end, the two Mii-vitaliSe facilitators' experiences of intervention delivery (main qualitative findings reported separately). RESULTS Mean (SD) age was 49.3 (8.7) years, 90% female, with 47% diagnosed with MS <6 years ago and 60% new to active gaming. The recruitment rate was 31% (95% CI 20% to 44%). Outcome data were available for 29 (97%) at 6 months and 28 (93%) at 12 months. No serious adverse events were reported during the study. Qualitative data indicated that Mii-vitaliSe was well-received. Mean Wii use across both groups over the initial 6-month intervention period was twice a week for 27 min/day. Mean cost of delivering Mii-vitaliSe was £684 per person. DISCUSSION Mii-vitaliSe appears acceptable and a future trial feasible and warranted. These findings will inform its design. TRIAL REGISTRATION ISRCTN49286846.
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Affiliation(s)
- Sarah Thomas
- Bournemouth University, Faculty of Health and Social Sciences, Bournemouth, Dorset, UK
| | - Louise Fazakarley
- Bournemouth University, Faculty of Health and Social Sciences, Bournemouth, Dorset, UK
| | - Peter W Thomas
- Bournemouth University, Faculty of Health and Social Sciences, Bournemouth, Dorset, UK
| | - Sarah Collyer
- Poole Hospital NHS Foundation Trust, Dorset Multiple Sclerosis Service, Poole, Dorset, UK
| | - Sarah Brenton
- Poole Hospital NHS Foundation Trust, Dorset Multiple Sclerosis Service, Poole, Dorset, UK
| | - Steve Perring
- Poole Hospital NHS Foundation Trust, Medical Physics, Poole, Dorset, UK
| | - Rebecca Scott
- National Star College, Cheltenham, Gloucestershire, UK
| | - Fern Thomas
- Bournemouth University, Faculty of Health and Social Sciences, Bournemouth, Dorset, UK
| | - Charlotte Thomas
- Bournemouth University, Faculty of Health and Social Sciences, Bournemouth, Dorset, UK
| | | | | | - Charles Hillier
- Poole Hospital NHS Foundation Trust, Dorset Multiple Sclerosis Service, Poole, Dorset, UK
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16
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Lupinacci G, Gatti G, Melegari C, Fontana S. Interactive design of patient-oriented video-games for rehabilitation: concept and application. Disabil Rehabil Assist Technol 2017; 13:234-244. [PMID: 28398175 DOI: 10.1080/17483107.2017.1306592] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Serious video-games are innovative tools used to train the motor skills of subjects affected by neurological disorders. They are often developed to train a specific type of patients and the rules of the game are standardly defined. A system that allows the therapist to design highly patient-oriented video-games, without specific informatics skills, is proposed. METHOD The system consists of one personal computer, two screens, a Kinect™ sensor and a specific software developed here for the design of the video-games. It was tested with the collaboration of three therapists and six patients, and two questionnaires were filled in by each patient to evaluate the appreciation of the rehabilitative sessions. RESULTS The therapists learned easily how to use the system, and no serious difficulties were encountered by the patients. The questionnaires showed an overall good satisfaction by the patients and highlighted the key-role of the therapist in involving the patients during the rehabilitative session. CONCLUSIONS It was found that the proposed system is effective for developing patient-oriented video-games for rehabilitation. The two main advantages are that the therapist is allowed to (i) develop personalized video-games without informatics skills and (ii) adapt the game settings to patients affected by different pathologies. Implications for rehabilitation Virtual reality and serious video games offer the opportunity to transform the traditional therapy into a more pleasant experience, allowing patients to train their motor and cognitive skills. Both the therapists and the patients should be involved in the development of rehabilitative solutions to be highly patient-oriented. A system for the design of rehabilitative games by the therapist is described and the feedback of three therapists and six patients is reported.
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Affiliation(s)
- Giorgia Lupinacci
- a Department of Mechanical, Energy and Management Engineering (DIMEG) , University of Calabria , Rende , Italy
| | - Gianluca Gatti
- a Department of Mechanical, Energy and Management Engineering (DIMEG) , University of Calabria , Rende , Italy
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17
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Rizzo JR, Thai P, Li EJ, Tung T, Hudson TE, Herrera J, Raghavan P. Structured Wii protocol for rehabilitation of shoulder impingement syndrome: A pilot study. Ann Phys Rehabil Med 2017; 60:363-370. [PMID: 28330586 DOI: 10.1016/j.rehab.2016.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 10/04/2016] [Accepted: 10/06/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To determine the feasibility and efficacy of using a structured Nintendo Wii protocol to improve range of motion, strength, and quality of life in patients with shoulder impingement syndrome. METHODS A total of 14 patients with shoulder pain were randomized to perform a structured Wii protocol (n=8) or conventional therapy (n=6). Pain-free shoulder range of motion, strength, shoulder pain and disability, and quality of life were assessed pre- and post-treatment. RESULTS All 8 patients completed the Wii protocol, and 3 completed conventional therapy. The Wii protocol conferred significant improvements in shoulder range of motion, pain and disability, and quality of life but not strength, whereas conventional therapy conferred a significant improvement in strength. CONCLUSIONS As compared to conventional treatment, the structured Wii protocol implemented in this pilot study was a viable adjunct to therapy for shoulder impingement syndrome. Gaming may have a supplemental benefit by increasing motivation, pleasure, and/or adherence. Further investigation in larger cohorts is warranted.
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Affiliation(s)
- John-Ross Rizzo
- Rusk Rehabilitation, New York University School of Medicine, New York University, New York, USA; Department of Neurology, New York University School of Medicine, New York University, New York, USA; Department of Psychology and Center for Neural Science, New York University, New York, USA
| | - Peter Thai
- Rusk Rehabilitation, New York University School of Medicine, New York University, New York, USA; College of Medicine, SUNY Upstate Medical University, New York, USA
| | - Edward J Li
- Mount Sinai School of Medicine, New York, USA
| | - Terence Tung
- Rusk Rehabilitation, New York University School of Medicine, New York University, New York, USA
| | - Todd E Hudson
- Rusk Rehabilitation, New York University School of Medicine, New York University, New York, USA; Department of Neurology, New York University School of Medicine, New York University, New York, USA
| | | | - Preeti Raghavan
- Rusk Rehabilitation, New York University School of Medicine, New York University, New York, USA; Department of Physical Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, USA.
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18
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Laut J, Porfiri M, Raghavan P. The Present and Future of Robotic Technology in Rehabilitation. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2016; 4:312-319. [PMID: 28603663 PMCID: PMC5461931 DOI: 10.1007/s40141-016-0139-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Robotic technology designed to assist rehabilitation can potentially increase the efficiency of and accessibility to therapy by assisting therapists to provide consistent training for extended periods of time, and collecting data to assess progress. Automatization of therapy may enable many patients to be treated simultaneously and possibly even remotely, in the comfort of their own homes, through telerehabilitation. The data collected can be used to objectively assess performance and document compliance as well as progress. All of these characteristics can make therapists more efficient in treating larger numbers of patients. Most importantly for the patient, it can increase access to therapy which is often in high demand and rationed severely in today's fiscal climate. In recent years, many consumer grade low-cost and off-the-shelf devices have been adopted for use in therapy sessions and methods for increasing motivation and engagement have been integrated with them. This review paper outlines the effort devoted to the development and integration of robotic technology for rehabilitation.
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Affiliation(s)
- Jeffrey Laut
- New York University Tandon School of Engineering
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19
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Nawaz A, Skjæret N, Helbostad JL, Vereijken B, Boulton E, Svanaes D. Usability and acceptability of balance exergames in older adults: A scoping review. Health Informatics J 2016; 22:911-931. [DOI: 10.1177/1460458215598638] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Serious games (exergames) have the potential to be effective for postural balance and increasing muscle strength. Several games have been developed to increase physical fitness and balance among older adults. However, it is unclear to which degree usability and acceptability of exergames for older adults have been evaluated. The aim of this study was to summarize usability evaluation and acceptability of studies in older adults. We conducted a scoping review on studies focusing on usability of exergames for older adults. The result shows that older adults consider usability and acceptability of exercise video games good. The review shows that longitudinal studies mainly use off-the-shelf exergame and evaluated game effectiveness and acceptability, whereas cross-sectional studies focus on interactional experience. Studies varied in their approaches to measure usability and acceptability of exergames for older adults. There is a need for a systematic developmental approach to involve older adults in development of exergames for longitudinal studies.
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Affiliation(s)
- Ather Nawaz
- Norwegian University of Science and Technology, Norway; Copenhagen Business School, Denmark
| | - Nina Skjæret
- Norwegian University of Science and Technology, Norway
| | | | | | | | - Dag Svanaes
- Norwegian University of Science and Technology, Norway
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20
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Harris DM, Rantalainen T, Muthalib M, Johnson L, Teo WP. Exergaming as a Viable Therapeutic Tool to Improve Static and Dynamic Balance among Older Adults and People with Idiopathic Parkinson's Disease: A Systematic Review and Meta-Analysis. Front Aging Neurosci 2015; 7:167. [PMID: 26441634 PMCID: PMC4561514 DOI: 10.3389/fnagi.2015.00167] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 08/17/2015] [Indexed: 11/25/2022] Open
Abstract
The use of virtual reality games (known as “exergaming”) as a neurorehabilitation tool is gaining interest. Therefore, we aim to collate evidence for the effects of exergaming on the balance and postural control of older adults and people with idiopathic Parkinson’s disease (IPD). Six electronic databases were searched, from inception to April 2015, to identify relevant studies. Standardized mean differences (SMDs) and 95% confidence intervals (CI) were used to calculate effect sizes between experimental and control groups. I2 statistics were used to determine levels of heterogeneity. 325 older adults and 56 people with IPD who were assessed across 11 studies. The results showed that exergaming improved static balance (SMD 1.069, 95% CI 0.563–1.576), postural control (SMD 0.826, 95% CI 0.481–1.170), and dynamic balance (SMD −0.808, 95% CI −1.192 to −0.424) in healthy older adults. Two IPD studies showed an improvement in static balance (SMD 0.124, 95% CI −0.581 to 0.828) and postural control (SMD 2.576, 95% CI 1.534–3.599). Our findings suggest that exergaming might be an appropriate therapeutic tool for improving balance and postural control in older adults, but more large-scale trials are needed to determine if the same is true for people with IPD.
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Affiliation(s)
- Dale M Harris
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University , Burwood, VIC , Australia
| | - Timo Rantalainen
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University , Burwood, VIC , Australia
| | - Makii Muthalib
- Movement to Health (M2H) Laboratory, Euromov, University of Montpellier , Montpellier , France
| | - Liam Johnson
- Clinical Exercise Science Research Program, Institute of Sport Exercise and Active Living (ISEAL), Victoria University , Melbourne, VIC , Australia ; The Florey Institute of Neuroscience and Mental Health, University of Melbourne , Melbourne, VIC , Australia
| | - Wei-Peng Teo
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University , Burwood, VIC , Australia
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