Sports Medicine Research: In the Lab & In the Field: Can Exergaming Bridge the Gap between Traditional Rehabilitation and At-Home Programs? (Sports Med Res)


Wednesday, December 18, 2013

Can Exergaming Bridge the Gap between Traditional Rehabilitation and At-Home Programs?

The Effect of Xbox Kinect Intervention on Balance Ability for Previously
Injured Young Competitive Male Athletes: A Preliminary Study

Vernadakis N, Derri V, Tsitskari E, Antoniou P. Phys Ther Sport. 2013 Sep 4. pii: S1466-853X(13)00070-9. doi: 10.1016/j.ptsp.2013.08.004. [Epub ahead of print]

Take Home Message: Gaming systems like the Microsoft Xbox Kinect demonstrate similar outcomes related to dynamic balance in the lower extremity, but increased levels of enjoyment and compliance.

Exergaming is becoming a popular activity for individuals looking to incorporate exercise into an interactive environment. It can be accomplished through systems like the Microsoft Xbox Kinect (XbK), which can detect movement without the need for a traditional controller. Exergaming has been linked to improved physiological effects and specifically, improvements in dynamic balance in the lower extremity. Since balance deficits have been identified as a risk factor for lower extremity injury, the authors of the current study aimed to compare balance outcomes, enjoyment, and compliance between an XbK intervention and traditional physiotherapy intervention among previously injured young competitive athletes. Sixty-three male soccer athletes participated in one of three groups: XbK, traditional physiotherapy, or control (no balance training). The authors included volunteers if they suffered two or more lateral ankle sprains in the last year, were not injured in the last month, currently played without restriction, or had no other musculoskeletal pathologies. A Biodex Stability System (BSS) measured two stability indices of dynamic balance at baseline: overall stability index (OSI) and limits of stability (LOS). Additionally, each participant completed a Physical Activity Enjoyment Scale (PACES) to assess enjoyment from the intervention. Finally, participants reported their compliance with the intervention program (XbK, traditional physiotherapy, or control).  The 10-week XbK intervention consisted of adventure games specifically for the console that increased difficulty as the intervention progress. The traditional physiotherapy, also 10 weeks long, entailed mini trampoline and BOSU ball exercises. The control group did not receive any balance intervention. The authors found that both intervention groups improved their balance compared with the control group during the ten week period. However, the authors did not find any differences between the two interventions. The participants who received the XbK intervention showed increased enjoyment and compliance compared to the traditional physiotherapy method.

Despite the authors not detecting any difference in balance measures between the two interventions, this study raises an excellent point regarding patient compliance and enjoyment with rehabilitation. With the widespread availability of systems like the Xbox Kinect in homes, clinicians can prescribe at-home programs that incorporate games on these systems. As compliance with at-home programs is usually suspect when a patient does not progress, exergaming may serve to increase the patient’s desire for at-home activity. Physical benefits of systems like the Xbox Kinect may be similar to traditional rehabilitation, but patients may perceive more control, satisfaction, and enjoyment with exergaming and are provided immediate feedback regarding performance. Exergaming can be supplementary to a patient’s rehabilitation as it removes barriers such as travel, time, and space requirements.

Questions for Discussion: Have you incorporated exergaming into your setting? Would you prescribe at-home rehabilitation exercises using a system like the Xbox Kinect?

Written By:  Laura McDonald
Reviewed by: Jeffrey Driban

Related Posts:

Vernadakis N, Derri V, Tsitskari E, & Antoniou P (2013). The effect of Xbox Kinect intervention on balance ability for previously injured young competitive male athletes: A preliminary study. Physical Therapy in Sport PMID: 24239167


Ada Weiss said...

This is really great information, especially for clinicians who work with younger patients. I think the fact that there was no statistical difference for balance outcomes between traditional rehab and exergaming is great for patients in the general athletic population. Youth sports and their resultant injuries may be the best fit for programs like this. Keeping kids happy, especially when they're injured and maybe can't participate in their normal sports, is very important not only to keep them motivated through physical activity but also to support them emotionally. Kids could play the balance games on their Xbox with friends and not have to feel different or limited. While I think youth athletes are a perfect fit for this type of activity, improving compliance for adults through fun rehab is also a positive outcome. Additionally, if the patient has access to the device at home, they can continue using it long after insurance would stop paying for physical therapy!

Jeffrey Driban said...

Great points Ada! Thanks!

Lamont Hill said...

Good post, a lot of sportsmen get the same situation in their lives, i also had pains due to my L3 disc gap and my chiropractor advised me some exercises and rest of at least 5 days. I did the same as it was quite costly session for me and thanks God i am well now and playing football as before. Nest time if i get any injury so i will use your Xbox therapy as it looks a totally new concept to get rid of pains.

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