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Published: 11 May 2012

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A group of scientists has found that video games such as Nintendo's Wii offer an enjoyable opportunity to promote light to moderate physical activity in children with CP, and may have a role to play in rehabilitation therapy. Their research is published online in the Archives of Physical Medicine and Rehabilitation.

According to the lead investigator Elaine Biddiss, PhD, of Toronto's Bloorview Research Institute at Holland Bloorview Kids Rehabilitation Hospital, and the University of Toronto, CanadA, active video games (AVG) provide a low-cost, commercially available system that can be strategically selected to address specific therapeutic goals

Seventeen children with CP were studied while playing four AVGs: Wii Bowling, Tennis, Boxing, and Dance Dance Revolution (DDR). Energy, motion, and muscle activity data were captured, and the children completed a survey to indicate their level of enjoyment playing the games. The researchers evaluated the intensity of the physical activity, the therapeutic potential of AVG play, and the practical considerations surrounding the use of AVGs for physical activity promotion.

They found that children with mild CP can attain moderate levels of physical activity during AVG play with games that require full body movements, such as Wii Boxing and DDR, but the activity is not vigorous enough to build endurance or strength. However, they did find that AVG play encourages repetitive movement and provides feedback to the user through on-screen avatars and game scores, which could promote neuroplastic change. The children reported high levels of enjoyment, which also enhances neuroplasticity.

Researchers found that certain games, such as Wii boxing, may be a good choice for encouraging and training faster wrist movements. This is important for children with CP as they commonly experience difficulty in extending their wrists. Children with hemiplegia, a form of CP that affects the limbs on one side of the body, frequently underutilize their affected limb regardless of their functional abilities. In the study, children engaged both upper limbs when playing Wii Boxing or DDR.

The range of motion of the dominant limb was well within the typical norms associated with upper limb movements in able-bodied individuals. While further safety studies are needed, this suggests that AVG should be a relatively low impact activity for children with CP. The researchers noted considerable variability in the participant's strategies to succeed in the game.

Participants may adapt a movement that minimizes physical effort to maximize in-game rewards. In a therapeutic setting, it may be necessary to train and provide rewards for appropriate movement styles. "While not a replacement for structured exercise and physical therapy, AVGs may encourage children with CP to be physically active and to practice complex motor activities.

There are many opportunities for further research. Future development and optimization of AVG technologies may usher in a new age in physical rehabilitation where virtual environments provide an arena for neuroplastic change in the comfort of one's home.

Citation: 

Active Video Game Play in Children With Cerebral Palsy: Potential for Physical Activity Promotion and Rehabilitation Therapies
Jennifer Howcroft, Sue Klejman, Darcy Fehlings, Virginia Wright, Karl Zabjek, Jan Andrysek, Elaine Biddiss. Archives of physical medicine and rehabilitation 9 May 2012 (Article in Press DOI: 10.1016/j.apmr.2012.02.033)

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Published: 07 May 2012

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The National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH) is requesting your input on version 2 of the Traumatic Brain Injury (TBI) Common Data Element (CDE) recommendations.  

The TBI CDEs were developed as the result of a U.S. multiagency collaboration between the National Institute of Neurological Disorders and Stroke (NINDS), the National Institute on Disability and Rehabilitation Research (NIDRR), the Department of Veterans Affairs (VA), and the Defense Centers of Excellence (DCoE).  This collaboration previously resulted in the development of Version 1.0 of the TBI CDEs. For Version 2.0, the CDEs have been organized according to type of TBI study (Concussion/mild TBI studies, Acute Hospitalized studies, Moderate/Severe TBI: Rehabilitation studies, and Epidemiology studies), the list of “Core” CDEs required for NINDS-funded studies has been reduced, and some gaps from Version 1.0 have been addressed. We hope you will take the time to review the CDEs. 

The NINDS CDE Web site fully describes the NINDS CDE Project and its goals.  In summary, the CDE Project aims to develop content standards, both generic and disease-specific, to enable clinical investigators to systematically collect, analyze, and share data across the research community.  Beginning in November 2011, a Working Group of over 50 TBI experts convened to work on refining the TBI CDEs for Version 2.0.  Investigators can choose from this catalog of CDEs when assembling their clinical study materials.  The TBI CDE Working Group has not attempted to define the complete universe of variables a clinical study might collect but rather to identify elements that will be useful across clinical studies. The TBI CDEs are being incorporated into the Federal Interagency Traumatic Brain Injury Research (FITBIR) database (http://fitbir.nih.gov/), which will further enable researchers to share data across the entire TBI research field.

The public review period for the TBI CDEs will take place through June 15, 2012.  During this time, Version 2.0 of the TBI CDEs will be publically available on the NINDS CDE Web site.  To access and review the TBI CDE recommendations, please follow the steps below:

1.       Navigate to http://www.commondataelements.ninds.nih.gov/TBI.aspx#tab=Data_Standards

2.       From the TBI CDE Standards page, on the Data Standards Tab, download the zip file containing the review package

3.       Unzip the zip file and read the “Overview document” for tips on how to conduct the review and submit your comments

The TBI CDE review package is categorized into the four different types of studies included above. Please feel free to provide comments on as many of the recommendations as you wish.  We look forward to your feedback and ask that you please submit your comments by Friday, June 15, 2012.  Please note, the CDEs will require refinement and validation, and the Call for Public Review is an important step in that ongoing process.  

Thank you in advance for taking the time to review the TBI CDEs. We hope that you will share this announcement with your colleagues and encourage them to provide feedback as well.

Sincerely,

This email address is being protected from spambots. You need JavaScript enabled to view it.
Program Director, Repair and Plasticity 
NIH/NINDS
301-496-1447

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Published: 01 May 2012

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Published: 25 April 2012

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