Gait Posture. 2012 Jul;36(3):372-7.
Clark RA, Pua YH, Fortin K, Ritchie C, Webster KE, Denehy L, Bryant AL.
Source: Department of Physiotherapy, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
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Sunday 6 January 2013
Thursday 3 January 2013
Video game-based coordinative training improves ataxia in children with degenerative ataxia.
Neurology. 2012 Nov 13;79(20):2056-60.
Ilg W, Schatton C, Schicks J, Giese MA, Schöls L, Synofzik M.
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Abstract
OBJECTIVE: Degenerative ataxias in children present a rare condition where effective treatments are lacking. Intensive coordinative training based on physiotherapeutic exercises improves degenerative ataxia in adults, but such exercises have drawbacks for children, often including a lack of motivation for high-frequent physiotherapy. Recently developed whole-body controlled video game technology might present a novel treatment strategy for highly interactive and motivational coordinative training for children with degenerative ataxias.
METHODS: We examined the effectiveness of an 8-week coordinative training for 10 children with progressive spinocerebellar ataxia. Training was based on 3 Microsoft Xbox Kinect video games particularly suitable to exercise whole-body coordination and dynamic balance. Training was started with a laboratory-based 2-week training phase and followed by 6 weeks training in children's home environment. Rater-blinded assessments were performed 2 weeks before laboratory-based training, immediately prior to and after the laboratory-based training period, as well as after home training. These assessments allowed for an intraindividual control design, where performance changes with and without training were compared.
RESULTS: Ataxia symptoms were significantly reduced (decrease in Scale for the Assessment and Rating of Ataxia score, p = 0.0078) and balance capacities improved (dynamic gait index, p = 0.04) after intervention. Quantitative movement analysis revealed improvements in gait (lateral sway: p = 0.01; step length variability: p = 0.01) and in goal-directed leg placement (p = 0.03).
CONCLUSIONS: Despite progressive cerebellar degeneration, children are able to improve motor performance by intensive coordination training. Directed training of whole-body controlled video games might present a highly motivational, cost-efficient, and home-based rehabilitation strategy to train dynamic balance and interaction with dynamic environments in a large variety of young-onset neurologic conditions.
CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that directed training with Xbox Kinect video games can improve several signs of ataxia in adolescents with progressive ataxia as measured by SARA score, Dynamic Gait Index, and Activity-specific Balance Confidence Scale at 8 weeks of training.
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Ilg W, Schatton C, Schicks J, Giese MA, Schöls L, Synofzik M.
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Abstract
OBJECTIVE: Degenerative ataxias in children present a rare condition where effective treatments are lacking. Intensive coordinative training based on physiotherapeutic exercises improves degenerative ataxia in adults, but such exercises have drawbacks for children, often including a lack of motivation for high-frequent physiotherapy. Recently developed whole-body controlled video game technology might present a novel treatment strategy for highly interactive and motivational coordinative training for children with degenerative ataxias.
METHODS: We examined the effectiveness of an 8-week coordinative training for 10 children with progressive spinocerebellar ataxia. Training was based on 3 Microsoft Xbox Kinect video games particularly suitable to exercise whole-body coordination and dynamic balance. Training was started with a laboratory-based 2-week training phase and followed by 6 weeks training in children's home environment. Rater-blinded assessments were performed 2 weeks before laboratory-based training, immediately prior to and after the laboratory-based training period, as well as after home training. These assessments allowed for an intraindividual control design, where performance changes with and without training were compared.
RESULTS: Ataxia symptoms were significantly reduced (decrease in Scale for the Assessment and Rating of Ataxia score, p = 0.0078) and balance capacities improved (dynamic gait index, p = 0.04) after intervention. Quantitative movement analysis revealed improvements in gait (lateral sway: p = 0.01; step length variability: p = 0.01) and in goal-directed leg placement (p = 0.03).
CONCLUSIONS: Despite progressive cerebellar degeneration, children are able to improve motor performance by intensive coordination training. Directed training of whole-body controlled video games might present a highly motivational, cost-efficient, and home-based rehabilitation strategy to train dynamic balance and interaction with dynamic environments in a large variety of young-onset neurologic conditions.
CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that directed training with Xbox Kinect video games can improve several signs of ataxia in adolescents with progressive ataxia as measured by SARA score, Dynamic Gait Index, and Activity-specific Balance Confidence Scale at 8 weeks of training.
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Balance recovery through virtual stepping exercises using Kinect skeleton tracking: a follow-up study with chronic stroke patients.
Stud Health Technol Inform. 2012;181:108-12.
Lloréns R, Alcañiz M, Colomer C, Navarro MD. Source Universitat Politècnica de València, Valencia, Spain.
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Abstract
Stroke patients often suffer from hemiparesis, which affects their balance condition and consequently their self-dependency and quality of life. Balance rehabilitation can be a long and tedious process. Virtual rehabilitation systems have been reported to provide therapeutic benefits to the balance recovery of stroke patients while increasing their motivation. This paper presents a follow-up study involving chronic stroke patients to evaluate the clinical effectiveness of a virtual stepping exercise using skeleton tracking through a low-cost Kinect depth sensor.
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Lloréns R, Alcañiz M, Colomer C, Navarro MD. Source Universitat Politècnica de València, Valencia, Spain.
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Abstract
Stroke patients often suffer from hemiparesis, which affects their balance condition and consequently their self-dependency and quality of life. Balance rehabilitation can be a long and tedious process. Virtual rehabilitation systems have been reported to provide therapeutic benefits to the balance recovery of stroke patients while increasing their motivation. This paper presents a follow-up study involving chronic stroke patients to evaluate the clinical effectiveness of a virtual stepping exercise using skeleton tracking through a low-cost Kinect depth sensor.
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Wednesday 2 January 2013
Physiologic Responses and Energy Expenditure of Kinect Active Video Game Play in Schoolchildren.
Stephen R. Smallwood, MSc; Michael M. Morris, MSc; Stephen J. Fallows, PhD; John P. Buckley, PhD
Archives of Pediatric and Adolescent Medicine. 2012;166(11):1005-1009.
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Abstract
OBJECTIVE To evaluate the physiologic responses and energy expenditure of active video gaming using Kinect for the Xbox 360.
DESIGN Comparison study.
SETTING Kirkby Sports College Centre for Learning, Liverpool, England.
PARTICIPANTS Eighteen school children (10 boys and 8 girls) aged 11 to 15 years.
MAIN EXPOSURE A comparison of a traditional sedentary video game and 2 Kinect activity-promoting video games, Dance Central and Kinect Sports Boxing, each played for 15 minutes. Physiologic responses and energy expenditure were measured using a metabolic analyzer.
MAIN OUTCOME MEASURES Heart rate, oxygen uptake, and energy expenditure.
RESULTS Heart rate, oxygen uptake, and energy expenditure were considerably higher (P < .05) during activity-promoting video game play compared with rest and sedentary video game play. The mean (SD) corresponding oxygen uptake values for the sedentary, dance, and boxing video games were 6.1 (1.3), 12.8 (3.3), and 17.7 (5.1) mL · min-1 · kg-1, respectively. Energy expenditures were 1.5 (0.3), 3.0 (1.0), and 4.4 (1.6) kcal · min-1, respectively.
CONCLUSIONS Dance Central and Kinect Sports Boxing increased energy expenditure by 150% and 263%, respectively, above resting values and were 103% and 194% higher than traditional video gaming. This equates to an increased energy expenditure of up to 172 kcal · h-1 compared with traditional sedentary video game play. Played regularly, active gaming using Kinect for the Xbox 360 could prove to be an effective means for increasing physical activity and energy expenditure in children.
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Archives of Pediatric and Adolescent Medicine. 2012;166(11):1005-1009.
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Abstract
OBJECTIVE To evaluate the physiologic responses and energy expenditure of active video gaming using Kinect for the Xbox 360.
DESIGN Comparison study.
SETTING Kirkby Sports College Centre for Learning, Liverpool, England.
PARTICIPANTS Eighteen school children (10 boys and 8 girls) aged 11 to 15 years.
MAIN EXPOSURE A comparison of a traditional sedentary video game and 2 Kinect activity-promoting video games, Dance Central and Kinect Sports Boxing, each played for 15 minutes. Physiologic responses and energy expenditure were measured using a metabolic analyzer.
MAIN OUTCOME MEASURES Heart rate, oxygen uptake, and energy expenditure.
RESULTS Heart rate, oxygen uptake, and energy expenditure were considerably higher (P < .05) during activity-promoting video game play compared with rest and sedentary video game play. The mean (SD) corresponding oxygen uptake values for the sedentary, dance, and boxing video games were 6.1 (1.3), 12.8 (3.3), and 17.7 (5.1) mL · min-1 · kg-1, respectively. Energy expenditures were 1.5 (0.3), 3.0 (1.0), and 4.4 (1.6) kcal · min-1, respectively.
CONCLUSIONS Dance Central and Kinect Sports Boxing increased energy expenditure by 150% and 263%, respectively, above resting values and were 103% and 194% higher than traditional video gaming. This equates to an increased energy expenditure of up to 172 kcal · h-1 compared with traditional sedentary video game play. Played regularly, active gaming using Kinect for the Xbox 360 could prove to be an effective means for increasing physical activity and energy expenditure in children.
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Tuesday 1 January 2013
Exergames for the elderly: towards an embedded Kinect-based clinical test of falls risk.
Stud Health Technol Inform. 2012;178:51-7.
Garcia JA, Felix Navarro K, Schoene D, Smith ST, Pisan Y.
University of Technology Sydney, FEIT, Australia.
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Abstract
Falls are the leading cause of disability, injuries or even death among older adults. Exercise programmes that include a balance component reduce the risk of falling by 40%. However, such interventions are often perceived as boring and drop-out rates are high. The characteristics of videogames may overcome this weakness and increase exercise adherence. The use of modern input devices, such as the Microsoft Kinect, enables quantification of player performance in terms of motor function while engaging with games. This capability has just started to be explored. The work presented in this paper focuses on the development of a Kinect-based system to deliver step training while simultaneously measuring parameters of stepping performance that have shown to predict falls in older people.
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Garcia JA, Felix Navarro K, Schoene D, Smith ST, Pisan Y.
University of Technology Sydney, FEIT, Australia.
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Abstract
Falls are the leading cause of disability, injuries or even death among older adults. Exercise programmes that include a balance component reduce the risk of falling by 40%. However, such interventions are often perceived as boring and drop-out rates are high. The characteristics of videogames may overcome this weakness and increase exercise adherence. The use of modern input devices, such as the Microsoft Kinect, enables quantification of player performance in terms of motor function while engaging with games. This capability has just started to be explored. The work presented in this paper focuses on the development of a Kinect-based system to deliver step training while simultaneously measuring parameters of stepping performance that have shown to predict falls in older people.
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Abstract
Clinically feasible methods of assessing postural control such as timed standing balance and functional reach tests provide important information, however, they cannot accurately quantify specific postural control mechanisms. The Microsoft Kinect™ system provides real-time anatomical landmark position data in three dimensions (3D), and given that it is inexpensive, portable and simple to setup it may bridge this gap. This study assessed the concurrent validity of the Microsoft Kinect™ against a benchmark reference, a multiple-camera 3D motion analysis system, in 20 healthy subjects during three postural control tests: (i) forward reach, (ii) lateral reach, and (iii) single-leg eyes-closed standing balance. For the reach tests, the outcome measures consisted of distance reached and trunk flexion angle in the sagittal (forward reach) and coronal (lateral reach) planes. For the standing balance test the range and deviation of movement in the anatomical landmark positions for the sternum, pelvis, knee and ankle and the lateral and anterior trunk flexion angle were assessed. The Microsoft Kinect™ and 3D motion analysis systems had comparable inter-trial reliability (ICC difference=0.06±0.05; range, 0.00-0.16) and excellent concurrent validity, with Pearson's r-values >0.90 for the majority of measurements (r=0.96±0.04; range, 0.84-0.99). However, ordinary least products analyses demonstrated proportional biases for some outcome measures associated with the pelvis and sternum. These findings suggest that the Microsoft Kinect™ can validly assess kinematic strategies of postural control. Given the potential benefits it could therefore become a useful tool for assessing postural control in the clinical setting.
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