Sports Medicine Research: In the Lab & In the Field: Exergaming Brings Postural Control Rehabilitation Up to a Whole New Level (Sports Med Res)


Monday, September 26, 2016

Exergaming Brings Postural Control Rehabilitation Up to a Whole New Level

Exergaming (XBOX Kinect™) versus traditional gym-based exercise for postural control, flow and technology acceptance in healthy adults: a randomised controlled trial

Barry G., van Schaik P., MacSween A., Dixon J., Martin D. BMC Sports Sci Med Rehabil. 2016;8(25):1–11.

Take Home Message: Exergaming using the XBOX KinectTM system has the potential to enhance postural control compared to standard gym-based exercise.

Exergaming – exercise using an interactive computer-generated environment – is increasingly implemented during physical rehabilitation. Gaming equipment can help a patient increase postural control. However, most of the research has been done among older adults using a WiiTM fit board, and not a KinectTM system, which allows a patient to move freely. Therefore, the authors developed a randomized control trial to investigate the effectiveness of exergaming using the XBOX KinectTM system compared with traditional gym-based exercise on postural control, technology acceptance, flow experience, and exercise intensity. The authors assessed 50 healthy participants (18 to 50 years of age). Following screening, 47 participants were randomized (3 were excluded: 1 amputee, 2 injured). The exergaming group played 6 games from KinectTM Adventures and Sports. The traditional gym-based exercise group performed exercises that were matched for sequence, intensity, duration, and mode of exercise. Each group completed the 3, 30-minute sessions per week for 4 weeks (12 sessions total). Participant’s intensity was progressed in each group at week 2 depending on proficiency of movement and the ability to match the skill level of the game (exergaming group) or by the supervising researcher working with the participants (traditional gym-based exercise group). Participants completed baseline testing to determine postural sway (stood on force plate for 5, 30 second periods on their dominant leg), technology acceptance UTAUT questionnaire (assessed factors that influences participant’s acceptance of the use of technology), and flow experience FSS questionnaire (measured 9 dimensions of flow in sport and physical activity settings). This was repeated following the 12th session. The authors also collected heart rate and rate of perceived exertion (6 was defined as no exertion at all and 20 was maximum exertion) at 10, 20, and 30 minute cycles during each session. Participants within the exergaming group demonstrated better postural sway scores in the frontal plane from baseline to 12th session compared with the traditional exercise group. There was no significant difference between groups for heart rate (~150 beats per minutes for each group); however, those in the exergaming group had lower perceived exertion (13) compared to the traditional exercise group (14). Participants within the exergaming group reported higher technology acceptance scores and higher scores in 6 of the 9 dimensions of flow experience compared with traditional exercise group.

Overall, the authors found that the XBOX KinectTM could improve postural control. Participants also reported higher technology acceptance and flow using the KinectTM system compared with those using traditional gym-based exercises. Interestingly, both groups ranged from ~61 to 80% of max heart rate, which indicates moderate level of intensity; however, the exergaming group reported a lower rate of perceived exertion. The authors attributed this to the immersive nature of exergaming and that it is more enjoyable compared with traditional exercise. It should be noted that the postural control scores were close between groups (KinectTM 28.3 mm vs. Traditional group 31.5 mm) by the 12th session so inferences about clinical relevance should be cautioned. It would be interesting to see how exergaming performs among people with balance deficits due to chronic ankle instability or recent injury. Overall, these findings are encouraging since postural control improved without the participant believing they worked that hard, which could help increase rehabilitation retention. Based on these results medical professionals should consider implementing the KinectTM system as a strategy to improve postural control.

Questions for Discussion: Would you implement exergaming to increase postural control in your athletes? Do you think this would be affordable and easy to implement rehabilitation option?

Written by: Jane McDevitt, PhD
Reviewed by: Jeff Driban

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Barry, G., van Schaik, P., MacSween, A., Dixon, J., & Martin, D. (2016). Exergaming (XBOX Kinect™) versus traditional gym-based exercise for postural control, flow and technology acceptance in healthy adults: a randomised controlled trial BMC Sports Science, Medicine and Rehabilitation, 8 (1) DOI: 10.1186/s13102-016-0050-0


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