Can a Wii or X-box console help stroke sufferers with their physical activity program?

Energy expenditure and exercise intensity of interactive video gaming in individuals poststroke

From Neurorehabilitation & Neural Repair

Individuals poststroke are prone to a sedentary lifestyle, with poor maintenance of long-term physical activity (PA). The American Heart Association and the American College of Sports Medicine recommend low to moderate intensity PA to promote health and vigorous PA for cardiovascular fitness. Activity-promoting video game (AVG) technologies like X-Box or Wii games may provide a worthwhile alternative for promoting PA. These technologies offer the potential of enhancing adherence, while being low cost, easy to operate, and widely available.

The aim of this study was to characterize the EE, exercise intensity, and energy metabolism of exercise in individuals poststroke while playing AVGs and to compare their performance with that of able-bodied individuals. It found playing AVGs might be a useful tool for increasing the PA of individuals poststroke at a level that can promote health and is similar to walking.



Background. Off-the-shelf activity-promoting video games (AVGs) are proposed as a tool for promoting regular physical activity among individuals poststroke. Objective. To characterize the energy expenditure (EE), exercise intensity, and energy metabolism of individuals poststroke, while playing AVGs in different positions, from different consoles, and to compare the performance with comfortable walking and with able-bodied individuals. Methods. Eleven poststroke and 8 able-bodied participants played in standing Wii-Boxing Xbox-Boxing, Wii-Run and Penguin, and also Wii-Boxing in sitting. EE (expressed as metabolic equivalents [METs]); exercise intensity (expressed as %predicted maximal heart rate [HR]), rate of perceived exertion (RPE), and respiratory exchange ratio (RER) were used to characterize the games. Results. Participants’ poststroke EE ranged from 1.81 ± 0.74 to 3.46 ± 1.3 METs and was lower compared with able-bodied participants for Xbox-Boxing (P = .001), Wii-Boxing in standing (P = .01), Run (P < .001), and Penguin (P = .001). Participants’ poststroke exercise intensity ranged from 49.8 ± 9.3 to 64.7 ± 9.3 %predicted maximal HR and was lower compared with able-bodied participants for Xbox-Boxing (P = .007) and Run (P = .005). For participants poststroke, EE of walking at a comfortable did not differ from boxing games in standing or Run. For able-bodied participants only, the EE for Xbox-Boxing was higher than Wii-Boxing (6.5 ± 2.6 vs 4.4 ± 1.1, P = .02). EE was higher in standing versus sitting for poststroke (P = .04) and able-bodied (P = .03) participants. There were no significant group differences for RPEs. RER of playing in sitting approached anaerobic metabolism. Conclusions. Playing upper extremity (ie, Boxing) or mobility (ie, Run) AVGs in standing resulted in moderate EE and intensity for participants poststroke. EE was lower for poststroke than for able-bodied participants.


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Article details
Michal Kafri, Mary Jane Myslinski, Venkata K. Gade, and Judith E. Deutsch
Energy Expenditure and Exercise Intensity of Interactive Video Gaming in Individuals Poststroke
Neurorehabil Neural Repair 1545968313497100, first published on July 29, 2013 doi:10.1177/1545968313497100





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