Wii!!! A pilot study shows benefits

Cat and Wii

In today’s Medscape email newsletter (so I can’t copy and paste) there is an article about an abstract presented at International Stroke Conference 2010 (so I can’t look it up on PubMed), but Wii Tennis and “Cooking Mama” improved task completion by 7 seconds over the control group who participated in the normal recreation therapy (22 subjects had a mild to moderate ischemic stroke, enrolling within 24 days on average, and mean age of 61). The time of the intervention was 2 weeks, and they tested the subjects four weeks later with the Wolf Motor Function Test (WMFT), the Box and Block Test, and the Stroke Impact Scale. For the WMFT, 1-2 second change is considered significant. The researchers hope to get a grant for a multi-center trial.

Here is the abstract from their proposed plan, published in February 2010:

Saposnik G, Mamdani M, Bayley M, Thorpe KE, Hall J, Cohen LG, Teasell R; EVREST Steering Committee; EVREST Study Group for the Stroke Outcome Research Canada Working Group.   Effectiveness of Virtual Reality Exercises in STroke Rehabilitation (EVREST): rationale, design, and protocol of a pilot randomized clinical trial assessing the Wii gaming system.  Int J Stroke. 2010 Feb;5(1):47-51.    Division of Neurology, Department of Medicine, St. Michael’s Hospital, University of Toronto, Toronto, Ontario. saposnikg@smh.toronto.on.ca

BACKGROUND: Evidence suggests that increasing intensity of rehabilitation results in better motor recovery. Limited evidence is available on the effectiveness of an interactive virtual reality gaming system for stroke rehabilitation. EVREST was designed to evaluate feasibility, safety and efficacy of using the Nintendo Wii gaming virtual reality (VRWii) technology to improve arm recovery in stroke patients. METHODS: Pilot randomized study comparing, VRWii versus recreational therapy (RT) in patients receiving standard rehabilitation within six months of stroke with a motor deficit of > or =3 on the Chedoke-McMaster Scale (arm). In this study we expect to randomize 20 patients. All participants (age 18-85) will receive customary rehabilitative treatment consistent of a standardized protocol (eight sessions, 60 min each, over a two-week period). OUTCOME MEASURES: The primary feasibility outcome is the total time receiving the intervention. The primary safety outcome is the proportion of patients experiencing intervention-related adverse events during the study period. Efficacy, a secondary outcome measure, will be measured by the Wolf Motor Function Test, Box and Block Test, and Stroke Impact Scale at the four-week follow-up visit. From November, 2008 to September, 2009 21 patients were randomized to VRWii or RT. Mean age, 61 (range 41-83) years. Mean time from stroke onset 25 (range 10-56) days. CONCLUSIONS: EVREST is the first randomized parallel controlled trial assessing the feasibility, safety, and efficacy of virtual reality using Wii gaming technology in stroke rehabilitation. The results of this study will serve as the basis for a larger multicentre trial. ClinicalTrials.gov registration# NTC692523.

Photo credit: Cat and Wii, originally uploaded by plynoi.

Addendum 3/30: in preparing for my lecture on adherence to exercise in older adults, I came across the blog ExerGame Lab, written by a professor at SUNY Cortland who researches “the effectiveness of using exergames and electronic games (egames) for healthy benefits.”  He also has a description of the study above.


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