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.

Exploring the electrophysiology and heritability of wellbeing and resilience

The majority of adults without a mental illness still experience poor mental health, indicating a need for a better understanding of what separates mental wellness from mental illness. One way of exploring what separates those with good mental health from those with poor mental health is to use electroencephalography (EEG) to explore differences in brain activity within the healthy population. Previous research has shown that EEG measures differ between clinical groups and healthy participants, suggesting that these measures are useful indicators of mental functioning. Miranda Chilver’s current project aims to examine how different EEG measures relate to each other and to test if they can be used to predict mental wellbeing. Furthermore, she hopes to distinguish between EEG markers of symptoms including depression and anxiety, and markers of positive symptoms of wellbeing to better understand how wellbeing can exist independently of mental illness. This will be done by obtaining measures of wellbeing and depression and anxiety symptoms using the COMPAS-W and DASS-42 questionnaires, respectively. Because EEG measures and mental wellbeing are both impacted by genetics as well as the environment, Miranda will also be testing whether the links found between EEG activity and Wellbeing are driven primarily by heritable or by environmental factors. This information will inform the development of future interventions that will aim to improve wellbeing in the general population. To achieve these goals, the project will assess the relationship between EEG activity and wellbeing, and between EEG and depression and anxiety symptoms to first test whether there is an association between EEG and mental health. Second, the heritability of the EEG, wellbeing, depression, and anxiety will be assessed to determine the extent to which these variables are explained through heritable or environmental factors. Finally, a model assessing the overlap between the heritable versus environmental contributions to each measure will be developed to assess whether genetics or environment drive the relationship between EEG and mental health. This project is based on a sample of over 400 healthy adult twins from the Australian TWIN-E study of resilience led by Dr Justine Gatt. This research will pave the way for improved mental health interventions based on individual needs.
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