title: Energy expenditure in adults with cerebral palsy playing Wii Sports.
abstract: OBJECTIVE
  To determine energy expenditure of adults with bilateral spastic cerebral palsy while playing Wii Sports tennis and boxing.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  University medical center.
  
  
  METHODS
  Five men and 3 women with bilateral spastic cerebral palsy and ambulatory ability (Gross Motor Function Classification System level I or II) participated. The mean participant age ± SD was 36±7 years. Exclusion criteria were comorbidities that affected daily physical activity and fitness, contraindications to exercise, or inability to understand study instructions owing to cognitive disorders or language barriers.
  
  
  METHODS
  Participants played Wii Sports tennis and boxing, each for 15 minutes in random order.
  
  
  METHODS
  By using a portable gas analyzer, we assessed energy expenditure by oxygen uptake (Vo(2)) while sitting and during Wii Sports game play. Energy expenditure is expressed in metabolic equivalents (METs), which were calculated as Vo(2) during Wii Sports play divided by Vo(2) during sitting.
  
  
  RESULTS
  Mean ± SD energy expenditure during Wii Sports game play was 4.5±1.1METs for tennis and 5.0±1.1METs for boxing (P=.024). All participants attained energy expenditures greater than 3METs, and 2 participants attained energy expenditures greater than 6METs while playing Wii Sports tennis or boxing.
  
  
  CONCLUSIONS
  Both Wii Sports tennis and boxing seem to provide at least moderate-intensity exercise in adults with bilateral spastic cerebral palsy (GMFCS level I or II). These games, therefore, may be useful as treatment to promote more active and healthful lifestyles in these patients. Further research is needed to determine the energy expenditures of other physically disabled patient groups while playing active video games, and to determine the effectiveness of these games in improving health and daily activity levels.
authors.affiliation: Department of Rehabilitation Medicine and Physical Therapy, Erasmus MC–University Medical Center, Rotterdam, The Netherlands. h.hurkmans@erasmusmc.nl
authors.forename: Henri L
authors.initials: HL
authors.lastname: Hurkmans
authors.forename: Rita J
authors.initials: RJ
authors.lastname: van den Berg-Emons
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Stam
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D002547:Cerebral Palsy / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D018910:Video Games