title: An in-depth, longitudinal examination of the daily physical activity of a patient with heart failure using a Nintendo Wii at home: a case report.
abstract: OBJECTIVE
  To explore the influence of the Nintendo Wii on the daily physical activity of a patient with chronic heart failure at home.
  
  
  METHODS
  A 74-year-old Swedish patient with heart failure had access to a Nintendo Wii at home for 12 weeks. Exercise motivation, exercise self-efficacy and exercise capacity were assessed before and after the intervention. Data on perceived physical effort, global well-being and expended energy were collected every day during the intervention.
  
  
  RESULTS
  During the 12 weeks of access to the Nintendo Wii, daily physical activity increased by 200% on weekdays and 57% on weekends, compared with baseline. The patient's exercise motivation and exercise self-efficacy increased during the study, whereas perceived physical effort and global well-being did not change. The patient had no difficulties in using the system and did not suffer any major harm.
  
  
  CONCLUSIONS
  The results of this case study suggest that providing patients with heart failure access to a Nintendo Wii is a promising and safe intervention. The energy expended by the patient per day increased, as did exercise capacity. Playing the Nintendo Wii did not increase the perceived physical effort, but increased motivation to exercise and decreased barriers to exercising.
authors.affiliation: Department of Social and Welfare Studies, Faculty of Health Science, Linköping University, 601 74 Norrköping, Sweden. Leonie.Klompstra@Liu.Se
authors.forename: Leonie Verheijden
authors.initials: LV
authors.lastname: Klompstra
authors.forename: Tiny
authors.initials: T
authors.lastname: Jaarsma
authors.forename: Anna
authors.initials: A
authors.lastname: Strömberg
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D004734:Energy Metabolism; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D015438:Health Behavior; D006333:Heart Failure / Q000503:physiopathology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D009042:Motivation; D005082:Physical Exertion; D020377:Self Efficacy; D018910:Video Games