Active videogames (AVGs) have potential in terms of physical activity and therapy for children with cerebral palsy. However, the effect of social interaction on AVG play has not yet been assessed. The objective of this study is to determine if multiplayer AVG versus solo affects levels of energy expenditure and movement patterns.
Subjects and Methods:
Fifteen children (9.77 [standard deviation (SD) 1.78] years old) with hemiplegic cerebral palsy (Gross Motor Function Classification System Level I) participated in solo and multiplayer Nintendo® “Wii™ Boxing” (Nintendo, Inc., Redmond, WA) AVG play while energy expenditure and punching frequency were monitored.
Results:
Moderate levels of physical activity were achieved with no significant differences in energy measures during multiplayer and solo play. Dominant arm punching frequency increased during the multiplayer session from 95.75 (SD 37.93) punches/minute to 107.77 (SD 36.99) punches/minute. Conversely, hemiplegic arm punching frequency decreased from 39.05 (SD 29.57) punches/minutes to 30.73 (SD 24.74) punches/minutes during multiplayer game play. Children enjoyed multiplayer more than solo play.
Conclusions:
Opportunities to play AVGs with friends and family may translate to more frequent participation in this moderate physical activity. Conversely, increased hemiplegic limb use during solo play may have therapeutic advantages. As such, new strategies are recommended to promote use of the hemiplegic hand during multiplayer AVG play and to optimize commercial AVG systems for applications in virtual reality therapy.
RimmerJ. Physical fitness levels of persons with cerebral palsy. Dev Med Child Neurol, 2001; 43:208–212.
3.
SutcliffeTL, LoganWJ, FehlingsDL. Pediatric constraint-induced movement therapy is associated with increased contralateral cortical activity on functional magnetic resonance imaging. J Child Neurol, 2009; 24:1230–1235.
4.
ParsonsTD, RizzoAA, RogersS, YorkP. Virtual reality in pediatric rehabilitation: A review. Dev Neurorehabil, 2009; 12:224–238.
5.
SandlundM, McDonoughS, Hager-RossC. Interactive computer play in rehabilitation of children with sensorimotor disorders: A systematic review. Dev Med Child Neurol, 2009; 51:173–179.
6.
DeutschJE, BorbelyM, FillerJet al.Use of a low-cost, commercially available gaming console (Wii) for rehabilitation of an adolescent with cerebral palsy. Phys Ther, 2008; 88:1196–1207.
7.
SniderL, MajnemerA, DarsaklisV. Virtual reality as a therapeutic modality for children with cerebral palsy. Dev Neurorehabil, 2010; 13:120–128.
8.
AndrysekJ, KlejmanS, SteinnagelBet al.Preliminary evaluation of a commercially available videogame system as an adjunct therapeutic intervention for improving balance among children and adolescents with lower limb amputations. Arch Phys Med Rehabil, 201; 93:358–366.
9.
SaposnikG, TeasellR, MamdaniMet al.Effectiveness of virtual reality using Wii gaming technology in stroke rehabilitation. Stroke, 2010; 41:1477–1484.
10.
MichelsenSI, FlachsEM, UldallPet al.Frequency of participation of 8–12-year-old children with cerebral palsy: A multi-centre cross-sectional European study. Eur J Paediatr Neurol, 2009; 13:165–177.
11.
EagleTF, GurmR, GoldbergCSet al.Health status and behavior among middle-school children in a Midwest community: What are the underpinnings of childhood obesity?Am Heart J, 2010; 160:1185–1189.
12.
KuhleS, AllenAC, VeugelersPJ. Prevention potential of risk factors for childhood overweight. Can J Public Health, 2010; 101:365–368.
13.
FaithMS, BermanN, HeoMet al.Effects of contingent television on physical activity and television viewing in obese children. Pediatrics, 2001; 107:1043–1048.
14.
MaloneyAE, Carter BetheaT, KelseyKSet al.A pilot of a video game (DDR) to promote physical activity and decrease sedentary screen time. Obesity, 2008; 16:2074–2080.
15.
HillierA. Childhood overweight and the built environment: Making technology part of the solution rather than part of the problem. Ann Am Acad Polit Soc Sci, 2008; 615:56–82.
16.
BiddissE, IrwinJ. Active video games to promote physical activity in children and youth. Arch Pediatr Adolesc Med, 2010; 164:664–672.
17.
AllenderS, CowburnG, FosterC. Understanding participation in sport and physical activity among children and adults: A review of qualitative studies. Health Educ Res, 2006; 21:826–835.
18.
PalisanoRJ, RosenbaumPL, WaltersSDet al.Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol, 1997; 39:214–223.
19.
WoodE, RosenbaumP. The Gross Motor Function Classification System for cerebral palsy: A study of reliability and stability over time. Dev Med Child Neurol, 2000; 42:292–296.
20.
EliassonAC, Krumlinde-SundholmL, RosbladBet al.The Manual Ability Classification System (MACS) for children with cerebral palsy: Scale development and evidence of validity and reliability. Dev Med Child Neurol, 2006; 48:549–554.
21.
MorrisC, KurinczukJJ, FitzpatrickR, RosenbaumPL. Reliability of the Manual Ability Classification System for children with cerebral palsy. Dev Med Child Neurol, 2006; 48:950–953.
ChisholmDM, CollisML, KulakLLet al.PAR-Q Validation Report: The Evaluation of a Self-Administered Pre-Exercise Screening Questionnaire for Adults. Victoria, BC: BC Ministry of Health and Health and Welfare Canada, 1978.
24.
HowcroftJ, KlejmanS, FehlingsDet al.Active video game play in children with cerebral palsy: Potential for physical activity promotion and rehabilitation therapies. Arch Phys Med Rehabil, 2012May3[Epub ahead of print]10.1016/j.apmr.2012.02.033.
25.
MelleckerRR, McManusAM. Energy expenditure and cardiovascular responses to seated and active gaming in children. Arch Pediatr Adolesc Med, 2008; 162:886–891.
26.
MelleckerRR, McManusAM, Lanningham-FosterLM, LevineJA. The feasibility of ambulatory screen time in children. Int J Pediatr Obes, 2009; 4:106–111.
27.
RobertsonRJ, GossFL, BoerNFet al.Children's OMNI Scale of Perceived Exertion: Mixed gender and race validation. Med Sci Sports Exerc, 2000; 32:452–458.
28.
BonettiAJ, DruryDG, DanoffJV, MillerTA. Comparison of acute exercise responses between conventional video gaming and isometric resistance exergaming. J Strength Cond Res, 2010; 24:1799–1803.
29.
BaranowskiT, AbdelsamadD, BaranowskiJet al.Impact of an active video game on healthy children's physical activity. Pediatrics, 2012; 129:e636–e642.
30.
Chin A PawMJM, JacobsWM, VaessenEPGet al.The motivation of children to play an active video game. J Sci Med Sport, 2008; 11:163–166.
31.
BorraS, SchwartzN, SpainC, NatchipolskyM. Food, physical activity, and fun: Inspiring America's kids to more healthful lifestyles. J Am Diet Assoc, 1995; 7:816–818.
32.
JaspersE, DesloovereK, BruyninckxHet al.Review of quantitative measurements of upper limb movements in hemiplegic cerebral palsy. Gait Posture, 2009; 30:395–404.
33.
GordonAM, CharlesJ, WolfSL. Methods of constraint-induced movement therapy for children with hemiplegic cerebral palsy: Development of a child-friendly intervention for improving upper-extremity function. Arch Phys Med Rehabil, 2005; 86:837–844.
34.
HaddockBL, SiegelSR, WikinLD. The addition of a video game to stationary cycling: The impact on energy expenditure in overweight children. Open Sports Sci J, 2009; 2:42–46.
35.
Lanningham-FosterL, JensenTB, FosterRCet al.Energy expenditure of sedentary screen time compared with active screen time for children. Pediatrics, 2006; 118:e1831–e1835.
36.
TanB, AzizAR, ChauK, TehKC. Aerobic demands of the dance simulation game. Int J Sports Med, 2002; 23:125–129.
37.
UnnithanVB, HouserW, FernhallB. Evaluation of the energy cost of playing a dance simulation video game in overweight and non-overweight children and adolescents. Int J Sports Med, 2006; 27:804–809.
38.
MaltaisDB, PierrynowskiMR, GaleaVA, Bar-OrO. Physical activity level is associated with the O2 cost of walking in cerebral palsy. Med Sci Sports Exerc, 2005; 37:347–353.
