The effects of exergaming on balance, gait, technology acceptance and flow experience in people with multiple sclerosis: a randomized controlled trial

Abstract

BackgroundExergaming is a promising new alternative to traditional modes of therapeutic exercise which may be preferable and more effective for people with Multiple Sclerosis (MS). Impaired balance is reported as one of the most disabling aspects of MS. The purposes of this study were to examine the effects of exergaming on: (1) postural sway, (2) gait, (3) technology acceptance and (4) flow experience in people with MS. Secondary outcomes were disability: 12‐item Multiple Sclerosis Walking Scale (MSWS-12) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) questionnaire.MethodsFifty-six adults (mean age = 52 years, SD = 5.8; 38 women) with a clinical diagnosis of MS and able to walk 100 meters with or without use of a walking aid were included in this study and randomized into 3 groups. Group 1 received balance training using the Nintendo Wii Fit™ (exergaming) and Group 2 undertook traditional balance training (non-exergaming). Group 3 acted as a control group, receiving no intervention. Exergaming and traditional balance training groups received four weeks of twice weekly balance-orientated exercise. Postural sway was measured using a Kistler™ force platform. Spatiotemporal parameters of gait were measured using a GAITRite™ computerised walkway. Technology acceptance and flow experience were measured using the Unified Theory of Acceptance and Use of Technology and the Flow State Scale questionnaires, respectively.ResultsThere were significant improvements in bipedal postural sway in both intervention groups when compared to the control group; and no effects of either intervention on gait. There were no significant differences between the interventions in technology acceptance but on several dimensions of flow experience the Wii Fit™ was superior to traditional balance training. Both interventions showed improvements in disability compared to control.ConclusionsIn terms of the physical effects of exergaming, the Wii Fit™ is comparable to traditional balance training. These findings would support the use of the Wii Fit™ as an effective means of balance and gait training for people with MS, which is both accepted and intrinsically motivating to MS users.Trial registrationControlled Trials ISRCTN13924231.

e-Health and multiple sclerosis: An update

“…28,29 However, when considering only patients with neurological conditions, exergames are equally effective for global cognitive functions and attention, and more effective for executive functions and visuo-spatial perception, compared with conventional therapies. 29 Apart from promising results in motor functions, 24 there is increasing evidence showing that motor exergames may prove beneficial in cognitive rehabilitation, 28 thus raising the hope that improved performance in a motor function may be beneficial for other untrained functional domains. 29 The effect of exergames (balance board video game) on sustained attention was investigated in a small crossover study on 21 pwMS.…”

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

“…Benefits have been reported in a range of clinical populations (people with neurological problems [3] children with cerebral palsy [4] and learning difficulties [5], Parkinson’ disease [6], multiple sclerosis [7] and older people [8, 9]). Balance training is an important focus of such rehabilitation.…”

Positive Technology, Computing, and Design: Shaping a Future in Which Technology Promotes Psychological Well-Being

“…One example is "transformation of flow"-the use of virtual reality to create artificial training environments that foster optimal experience by promoting unexpected psychological resources and sources of involvement (Riva et al, 2004(Riva et al, , 2006. For example, Robinson et al (2015) examined the effects of "exergaming" (short for exercise video-games) against conventional training (balance training) on functional outcomes and flow experience in people with multiple sclerosis. This approach has shown promising results in the field of rehabilitation (Borghese et al, 2013;Shin et al, 2014;Robinson et al, 2015).…”