title: Energy expenditure and exercise intensity of interactive video gaming in individuals poststroke.
abstract: BACKGROUND
  Off-the-shelf activity-promoting video games (AVGs) are proposed as a tool for promoting regular physical activity among individuals poststroke.
  
  
  OBJECTIVE
  To characterize the energy expenditure (EE), exercise intensity, and energy metabolism of individuals poststroke, while playing AVGs in different positions, from different consoles, and to compare the performance with comfortable walking and with able-bodied individuals.
  
  
  METHODS
  Eleven poststroke and 8 able-bodied participants played in standing Wii-Boxing Xbox-Boxing, Wii-Run and Penguin, and also Wii-Boxing in sitting. EE (expressed as metabolic equivalents [METs]); exercise intensity (expressed as %predicted maximal heart rate [HR]), rate of perceived exertion (RPE), and respiratory exchange ratio (RER) were used to characterize the games.
  
  
  RESULTS
  Participants' poststroke EE ranged from 1.81 ± 0.74 to 3.46 ± 1.3 METs and was lower compared with able-bodied participants for Xbox-Boxing (P = .001), Wii-Boxing in standing (P = .01), Run (P < .001), and Penguin (P = .001). Participants' poststroke exercise intensity ranged from 49.8 ± 9.3 to 64.7 ± 9.3 %predicted maximal HR and was lower compared with able-bodied participants for Xbox-Boxing (P = .007) and Run (P = .005). For participants poststroke, EE of walking at a comfortable did not differ from boxing games in standing or Run. For able-bodied participants only, the EE for Xbox-Boxing was higher than Wii-Boxing (6.5 ± 2.6 vs 4.4 ± 1.1, P = .02). EE was higher in standing versus sitting for poststroke (P = .04) and able-bodied (P = .03) participants. There were no significant group differences for RPEs. RER of playing in sitting approached anaerobic metabolism.
  
  
  CONCLUSIONS
  Playing upper extremity (ie, Boxing) or mobility (ie, Run) AVGs in standing resulted in moderate EE and intensity for participants poststroke. EE was lower for poststroke than for able-bodied participants.
authors.affiliation: 1University of Medicine and Dentistry of New Jersey, Newark, NJ, USA.
authors.forename: Michal
authors.initials: M
authors.lastname: Kafri
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Myslinski
authors.forename: Venkata K
authors.initials: VK
authors.lastname: Gade
authors.forename: Judith E
authors.initials: JE
authors.lastname: Deutsch
mesh_terms: D000328:Adult; D004734:Energy Metabolism / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D018910:Video Games
keywords: energy expenditure; exercise; health; physical activity; stroke; video games