NeuRA Magazine #20

IMPROVING HEALTH WITH A WII

Using Wii computer games as rehabilitation therapy has proven to be beneficial for people after a stroke. New research has shown it can also improve their fitness.

Dr Penelope McNulty with a research participant

Wii-based Movement Therapy (WMT) not only restores upper limb mobility, but also improves lower limb movement and cardiovascular health in people after a stroke, according to two new studies by Dr Penelope McNulty.

Both studies compared WMT with modified Constraint-induced Movement Therapy (mCMIT) and found that WMT boasts additional benefits. While CMIT is currently considered best-practice in stroke rehabilitation, results from these studies indicate that WMT is equally as effective, with better lifestyle outcomes at six months.

Sixty-five percent of people living with stroke suffer a disability that impedes their ability to carry out daily living activities unassisted. Sedentary behaviour is common after a person has suffered a stroke, with cardiovascular fitness typically around half that of healthy people of a similar age. Poor cardiovascular fitness is a significant risk factor for subsequent stroke and is responsible for 19 percent of stroke readmissions.

“Our study shows us that Wii-based therapy provides three essential benefits to stroke survivors,” says neurophysiologist Dr Penelope McNulty. “After receiving this treatment their stepping as well as arm and hand movements were improved and many enjoyed the additional benefit of increased cardiovascular fitness. We were pleasantly surprised with these results.”

WMT provides neurorehabilitation, resulting in multi-domain improvements in limb movement and fitness, according to researchers.

The Wii-based therapy involved 60-minute sessions per day of an individually tailored program involving Wii-Sports (golf, bowling, baseball, tennis or boxing). Game activities were introduced and varied according to motor function and progress of each patient.

“Our research emphasises the need to increase physical activity post-stroke. We have shown that WMT is as effective for upper limb rehabilitation as mCIMT and, crucially, it has the added benefit of having higher patient preference, so they’re likely to adhere to their rehabilitation training for longer.”

Researchers say that WMT can be tailored to address aerobic deconditioning that affects around 50 percent of stroke survivors without compromising its focus on improving upper limb function.

Dr McNulty believes that with few minor modifications, Wii-based Movement Therapy can be individualised to provide a carefully controlled cardiovascular rehabilitation option for stroke survivors.

“Our research highlights the importance of developing a therapy that focuses on enabling increased independence post-stroke, and that the Wii-based Movement Therapy can deliver benefits that have been overlooked by current standard therapies.”

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FEEL THE BUZZ IN THE AIR? US TOO.

ReacStep – novel balance training programs to prevent falls in older adults

The ReacStep study is investigating the short-term effects of two balance training programs (i.e. reactive balance training and conventional balance training) on balance recovery from slips and trips in older adults. These programs are designed from evidence-based research and offer a challenging and unique experience to improving balance. The ReacStep team are calling on volunteers who: are aged 65 and over living independently in the Sydney metropolitan community can walk 500m comfortably with mobility aids or rest have not been advised by a medical practitioner not to exercise have no neurological conditions (e.g. Parkinson’s Disease, multiple sclerosis, Alzheimer’s, dementia, etc.) have no history or lower limb, pelvic or vertebral fracture(s) and/or lower limb joint replacement(s) in the past 6 months have no other existing conditions that may prevent them from exercising (e.g. injury, pain, fatigue, etc.) Eligible volunteers will be subjected to a health and safety screening before they are enrolled and randomly allocated into one of the two groups. Both groups will undertake a 3-week training program with an exercise physiologist, at NeuRA (i.e. in Randwick) as well as a balance recovery assessment at the 4-week time point. Reactive balance training involves intentionally stepping on a sliding tile, stepping over obstacles, trigger-release recovery as well as strength training. Participants will be wearing a full-body safety harness to ensure safety. Conventional balance training involves keeping balance in varying foot positions (i.e. feet together, in tandem or on one leg) whilst performing secondary tasks such as throwing a ball, card sorting, solving a maze or playing computer games. For more detailed information, read the Participant Information Statement and watch the video below. To get involved or to register your interest, click HERE. For all other queries, please contact the ReacStep Team on 02 9399 1002 or reactstep-study@neura.edu.au. HC210350 https://youtu.be/55q5pK0kjqY
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