Thursday, October 4, 2012

Wii Fit Improves Balance in Children with CP (Study)

Can a 3 week physio regiment improve balance, running speed and agility in children with Cerebral Palsy (CP)? The first question before the investigators should have asked is if 3 weeks is a typical regiment length that sees improvement in those areas? If so, then ask the question if Wii Fit can be used in place of the traditional modalities. According to their findings, these children did not see a significant improvement in RSA scales, but balance scores did improve significantly. (Photo credit via wn.com)
Jelsma J, Pronk M, Ferguson G, & Jelsma-Smit D (2012). The effect of the Nintendo Wii Fit on balance control and gross motor function of children with spastic hemiplegic cerebral palsy. Developmental neurorehabilitation PMID: 23030836

Exergaming Points to Ponder (P2P)
  • Which games did they play in Wii Fit?
  • Were there 2 separate groups or was it a multiple baseline-design?
  • Although the changes may not have been statistically significant, were they clinical significant?
  • Were the changes over time compared to a traditional treatment group?
  • What assurances were there to mimic traditional tasks with the Wii Fit activities?
  • Was the total amount of time in therapy exactly the same as a traditional 3-week regiment? During a typical treatment period of 3 weeks, what would typically be the level of improvment occurring in patients.
  • Its interesting that they tested the children on running when for the most part there is no running feature in Wii Fit except for Free Run.
Objective: To study the impact of training using the Nintendo Wii Fit in 14 children with spastic hemiplegic cerebral palsy. Methods: A single-subject single blinded design with multiple subjects and baselines was utilised. Interactive video gaming (IVG) in lieu of regular physiotherapy was given for 3 weeks. Outcome measures included modified balance and running speed and agility (RSA) scales of the Bruininks-Oserestky test of Motor Performance 2 and the timed up and down stairs (TUDS). Results: Balances score improved significantly (F(2, 26) = 9.8286, p = 0.001). Changes over time in the RSA (F(2, 26) = 0.86198, p = 0.434) and the TUDS (F(2, 26) = 1.3862, p = 0.268) were not significant. Ten children preferred the intervention to conventional physiotherapy. Conclusion: Most children preferred the IVG but as the effect did not carry over into function, IVG should not be used in place of conventional therapy and further research is needed into its use as an adjunct to therapy.

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