Exercise works for all

Design: Cross-sectional study
Evaluating exercise intensity levels in children with cerebral palsy playing the Wii Robert, M., Ballaz, L., Hart, R & Lemay, M, Physical Therapy, Early online, April 11, 2013 DOI: 10.2.2522/ptj.20120204

Link to abstract: http://www.ncbi.nlm.nih.gov/pubmed/23580626

Objective: Measuring the difference in exercise intensity of children with cerebral palsy compared with typically developing children playing the Wii Fit.

Method: Ten 7-to-12 year old children with spastic diplegic cerebral palsy (GMFCS I or II) were matched with 10 typically developing children. All children played one session of four Wii Fit (lower-extremity focused) games of 10 minutes duration. Heart rate was measured and exercise intensity was measured as percent of heart rate reserve.

Results: No difference was observed between groups for time spent at an intensity of > 40% of heart rate reserve across all games.

Assessing object tracking with gameplay

Development article: Assessing multiple object tracking in young children using a game
Ryokai, K., Farzin, F., Kaltman, E. & Niemeyer, G.
Education Technology Research Development (2013) 61:153-170 DOI 10.1007/s11423-012-9278-x

Link to article: people.ischool.berkeley.edu/~kimiko/papers/ETRD2012.Ryokai.TrackFX.pdf

Multiple object tracking (MOT) - identifying, visually tracking and maintaining continued attention to multiple moving objects, is both a complex and a critical life skill. Object tracking skills increase between childhood and young adulthood.

Objective: There is little understanding of the emergence of MOT in young children. The authors create an MOT assessment task that engages children from 30 months of age, uses touch or tangible interface, and has scientific validity. They pose the questions:“Can young children under the age of five interact with digital objects on a touch-tablet to accomplish a visual-motor task such as MOT?” and “Would young children’s tracking ability improve over time with more game play?”. Transferability “do computer games transfer to the real world”, effective game design and choice of the tablet as a touch or tangible user interface arise as issues in this MOT assessment’s creation.

Findings: 31 children between 30 and 58 months each played an average of six sessions. This group could track an average of three objects or one object with two distracters. The threshold of successful game play did not vary within this age group. Within sessions, children’s play did not differ from adults when the game presented three or less objects (without distracters), but differed significantly as four or more objects were presented, or when distracting objects were present. Across sessions, the study did not demonstrate a learning effect (possibly due to a large number of subjects who played only two sessions) and an overall decline in performance after six sessions, (possibly due to distracted attention).

Is Wii better than standard balance therapy?

Single-subject research

Wii-habilitation as balance therapy for children with acquired brain injury

Tatla, S. K., Radomski, A., Cheung, J., Maron, M. & Jarus, T. Developmental Neurorehabilitation, 2012, 1 – 15, Early Online

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/23231377

Objective: Comparing Nintendo Wii balance therapy to standard therapeutic balance activities for change in balance, motivation and functional ability in children during brain injury rehabilitation.

Method: Single subject testing occurred over four weeks. Three subjects were randomly assigned to one of several protocols that provided standard therapeutic balance activities (baseline) either following or preceding Wii balance activities. Each condition was delivered as a 30-minute therapy, five times a week. Balance was measured with the Timed Up and Go (TUG) test, the Modified Functional Reach Test (MFRT) and the Wii-Fit balance board; motivation by the use of the Pediatric Motivation Scale, and functional abilities with the Pediatric Evaluation of Disability Index (PEDI).

Findings: Dynamic balance improved for all participants regardless of whether baseline followed or preceded Wii balance therapy and static balance results were inconclusive. Balance activities were equally motivating for 2 of 3 subjects and Wii balance activities were more motivating for one. Functional ability improved for all participants regardless of whether baseline followed or preceded Wii balance therapy.

Gamer's Accessibility Holiday Guides

Ablegamers http://www.ablegamers.com evaluates game software, hardware and devices. Games are rated on scales for visual, auditory and movement requirements.

Ablegamers have released their annual “Holiday Gift guide for disabled gamers”. http://www.ablegamers.com/Disabled-Gamers-General-News/ablegamers-holiday-gift-guide-for-disabled-gamers-2012.html

DAGERS http://dagersystem.com/ evaluates games to characterize the accessibility of the video game software. The DAGERS system considers how limitations in auditory, visual and fine motor performance limit being able to advance through the game. DAGERS currently rates games as inaccessible, partly, thoroughly accessible or barrier free. DAGERS have also produced a “Holiday accessibility buying guide” http://dagersystem.com/index.php/features/45-featured/117-holiday-buying-guide

Games for Health Journal - Volume 1, Number 4

Table of Contents
http://online.liebertpub.com/toc/g4h/1/4

Original Articles

Acceptability of an Online Health Videogame to Improve Diet and Physical Activity in Elementary School Students: “Fitter Critters”; Kristin L. Schneider, John Ferrara, Bri Lance, Andrew Karetas, Susan Druker, Emily Panza, Barbara Olendzki, Victoria Andersen, and Lori Pbert
Link to abstract: //online.liebertpub.com/doi/abs/10.1089/g4h.2012.0009

Improvements in Dynamic Balance Using an Adaptive Snowboard with the Nintendo Wii; Brendan Sullivan, Alexandra G. Harding, John Dingley, and Laura Z. Gras
Link to abstract: //online.liebertpub.com/doi/abs/10.1089/g4h.2012.0006

Looking Similar Promotes Group Stability in a Game-Based Virtual Community, Catherine L. Lortie and Matthieu J. Guitton
Link to abstract: //online.liebertpub.com/doi/abs/10.1089/g4h.2012.00016

When Losing Means Winning: The Impact of Conflict in a Digital Game on Young Adults' Intentions to Get Protected from Cancer, Georges E. Khalil
Link to abstract: //online.liebertpub.com/doi/abs/10.1089/g4h.2012.0017

A Comparison of Solo and Multiplayer Active Videogame Play in Children with Unilateral Cerebral Palsy; Jennifer Howcroft, Darcy Fehlings, Virginia Wright, Karl Zabjek, Jan Andrysek, and Elaine Biddiss
Link to abstract: //online.liebertpub.com/doi/abs/10.1089/g4h.2012.0015

Clinical Briefs

A Qualitative Study to Inform the Development of a Videogame for Adolescent Human Immunodeficiency Virus Prevention; Kimberly Hieftje, Marjorie S. Rosenthal, Deepa R. Camenga, E. Jennifer Edelman, and Lynn E. Fiellin
Link to abstract: //online.liebertpub.com/doi/abs/10.1089/g4h.2012.0025

Gamification and the Internet: Experts Expect Game Layers to Expand in the Future, with Positive and Negative Results; Janna Anderson and Lee Rainie
Link to abstract: //online.liebertpub.com/doi/abs/10.1089/g4h.2012.0027

Using Alice 2.0 to Design Games for People with Stroke, Rachel Proffitt, Caitlin Kelleher, M. Carolyn Baum, and Jack Engsberg
Link to abstract: //online.liebertpub.com/doi/abs/10.1089/g4h.2012.0029

Using Games to Improve Functioning in Children with Fetal Alcohol Spectrum Disorders, Jacqueline Pei and Kimberly Kerns
Link to abstract: //online.liebertpub.com/doi/abs/10.1089/g4h.2012.0036

Importance of Patient Culture and Exergaming Design for Clinical Populations: A Case Series on Exercise Adherence in Soldiers with Depression; Greg M. Reger, Kevin M. Holloway, Joe Edwards, and Amanda Edwards-Stewart
Link to abstract: //online.liebertpub.com/doi/abs/10.1089/g4h.2012.0014

Letter to the Editor
Games for Health: A Rookie’s Observations, Marc L. Demers

Interview
Using Health Games for Physical Therapy: An Interview with Ernie Medina, DrPH
Link to abstract: //online.liebertpub.com/doi/abs/10.1089/g4h.2012.0028

Review
Fun and Games and Boredom; Richard Buday, Tom Baranowski, and Debbe Thompson
Link to abstract: //online.liebertpub.com/doi/abs/10.1089/g4h.2012.0026

Roundtable Discussion
Game Interventions for Autism Spectrum Disorder Moderator: Bill Ferguson, Participants: Cay Anderson-Hanley, Micah O. Mazurek, Sarah Parsons, and Zachary Warren

Program Profile
The Road Not Traveled: The Role of Telehealth in the New Era of Mobile Healthcare, Terry Duesterhoeft

Video games for physical therapy

Single group experimental study

Active Video Game Play in Children with Cerebral Palsy: Potential for Physical Activity Promotion and Rehabilitation Therapies

Howcroft, J., Klejman, S., Fehlings, D., Wright, V., Zabjek, K., Andrysek, J., & Biddiss, E. Arch Phys Med Rehabil Vol 93, August 2012; pp.1448 – 1456

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/22571917

Objective: How much energy do children with cerebral palsy expend and how much enjoyment do they find in active video games (AVG)?

Method: 17 children with mean age 9.43 years, GMFCS level 1, played 4 active video games for 8 minutes.

Findings: Children were instrumented with portable cardiopulmonary and optical motion capture equipment, and single differential surface electrodes. Moderate levels of physical activity; 3.2 and 3.36 METs (metabolic equivalent for task) were recorded, as was a high level of enjoyment; 4.5 out of 5 on the PACES (physical activity enjoyment scale). This study elicited differences across dominant and hemiplegic limbs’ range of movements, angular velocity and acceleration.

“Children with mild levels of cerebral palsy can attain moderate levels of physical activity during AVG play with games that require full body movements”. AVGs have the benefits of promoting physical activities and securing higher engagement in physical rehabilitation therapies.

Towards a core set of gaming outcomes

Gaming supports youth with acquired brain injury? A pilot study

de Kloet, A. J., Berger, M. A., Verhoeven, I. M., van Stein Callenfels, K., & Vliet Vleiland, T. P. Brain Injury, 2012, May 25, 1 – 9, Early Online

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/22632604

Objective: Do children and young adults with brain injury benefit from Nintendo Wii sessions?

Method: Fifty 6 – 29 year olds with acquired brain injury were required to independently play at least two hours of Wii games weekly for 12 weeks. Participants were interviewed to help self-identify three limitations to activities of daily living; three Nintendo games were matched to individual’s interests and limitations via a protocol called “TherapyWii”, available at www.TherapyWii.nl

Participants were assessed before and after the intervention. The Children’s Assessment of Participation and Enjoyment (CAPE), the Amsterdam Neurological Tasks (ANT), Goal Attainment Scaling (GAS), Pediatric Quality-of-Life Inventory (PedsQL) were used.

Findings: Two thirds of the participants reported improvement towards their self-identified goals, mostly in gross motor performance and information processing. Significant changes were seen in the level of physical activity (CAPE), speed of processing information, attention, response inhibition, and visual-motor coordination (ANT). No difference was seen for PedsQL.

The authors make a call for a core set of outcomes for studies of virtual reality and interactive video gaming in patients with brain injury. This study “substantiates the potential benefits of gaming in patients with ABI”.