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

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]

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?

By:  Laura McDonald
by: Jeffrey Driban


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