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

G., van Schaik P., MacSween A., Dixon J., Martin D. BMC Sports Sci Med Rehabil.

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

– 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.

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

Jane McDevitt, PhD
by: Jeff Driban


Accuracy, Affordability, and Portability! Use Your Tablet To Detect Postural Instability

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