Original article
Video Game–Based Exercises for Balance Rehabilitation: A Single-Subject Design

Presented in part to the IASTED International Conference on Advances in Computer Science and Technology, January 2006, Puerto Vallarta, Mexico.
https://doi.org/10.1016/j.apmr.2006.04.010Get rights and content

Abstract

Betker AL, Szturm T, Moussavi ZK, Nett C. Video game–based exercises for balance rehabilitation: a single-subject design.

Objectives

To investigate whether coupling foot center of pressure (COP)–controlled video games to standing balance exercises will improve dynamic balance control and to determine whether the motivational and challenging aspects of the video games would increase a subject’s desire to perform the exercises and complete the rehabilitation process.

Design

Case study, pre- and postexercise.

Setting

University hospital outpatient clinic.

Participants

A young adult with excised cerebellar tumor, 1 middle-aged adult with single right cerebrovascular accident, and 1 middle-aged adult with traumatic brain injury.

Intervention

A COP-controlled, video game–based exercise system.

Main Outcome Measures

The following were calculated during 12 different tasks: the number of falls, range of COP excursion, and COP path length.

Results

Postexercise, subjects exhibited a lower fall count, decreased COP excursion limits for some tasks, increased practice volume, and increased attention span during training.

Conclusions

The COP-controlled video game–based exercise regime motivated subjects to increase their practice volume and attention span during training. This in turn improved subjects’ dynamic balance control.

Section snippets

Methods

This section first gives an overview of the COP-controlled video games and their integration with the Force Sensitive Applications (FSA) pressure mapping system.a Next, the exercise program is discussed, detailing the research design, test protocol, and outcome measures used to validate the video game tool as an effective exercise program.

Results

The results of the questionnaires were very positive. The 3 subjects reported that they had fun playing the video game–based balance exercises and often lost track of time. They stated that they greatly preferred the training sessions with video games over the exercise programs they have performed in the past. The video games were challenging to play and were adjusted to meet the needs and performance levels of each subject.

Discussion

Our COP-controlled video game–based exercises were found to improve subjects’ dynamic balance control. Most important, postexercise case 1 and case 2 exhibited a decrease in their fall rate and case 3 was able to independently maintain standing balance for 20 seconds. For case 1, the COP excursion and path length values decreased postexercise for all tasks where standing balance was maintained pre- and postexercise. The values for case 2 were more variable. For tasks where case 2 maintained

Conclusions

Our goal was to evaluate the benefits of our video game–based exercise regime, by quantifying the amount of recovery pre-exercise versus postexercise. Our findings demonstrated that graded, dynamic balance exercises on different surfaces can be effectively coupled to video game play. In addition to the training program being enjoyable, all 3 subjects improved their fall rate performance as a result of the video game–based exercise therapy. The ability to customize our system to each subject’s

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    Supported by the Manitoba Health Research Council (studentship), Natural Sciences and Engineering Research Council (fellowship), and Riverview Health Centre Research Foundation.

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

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