title: Evaluating the Nintendo Wii for assessing return to activity readiness in youth with mild traumatic brain injury.
abstract: Adolescents with mild traumatic brain injuries (MTBI) are at substantial risk for repeat injury if they return to activity too soon. Post-concussion symptoms and impaired balance are two factors that limit return to activity. Post-injury assessments that challenge activity tolerance and balance skills are needed to ensure readiness to return to activity. This cross-sectional study evaluated the Nintendo Wii as a measure of exertion (heart rate [HR], respiration rate [RR], and caloric expenditure) and balance testing for youth with MTBI in a clinical setting. Twenty-four youth with MTBI, ages 9-18, played six Wii games. The Bruininks-Oseretsky Test of Motor Proficiency 2nd edition (BOT-2) and the Community Balance and Mobility Scale (CBM) were used as balance indicators. The Wii Fit Running game demonstrated the highest caloric expenditure and HR (p = .010). Frequency counts of balance loss during Wii game play did not correlate with performance on the BOT-2 or the CBM. Type, number, and time since injury were predictive of balance performance on the CBM (p = .008). Findings provide preliminary evidence for the use of the Wii as an exertion challenge to evaluate tolerance for exercise post-concussion. Frequency count of balance loss during Wii game play, however, was not a valid measure of balance impairment post-MTBI.
authors.affiliation: 1McMaster Children's Hospital, Hamilton, Ontario, Canada.
authors.forename: Carol
authors.initials: C
authors.lastname: DeMatteo
authors.forename: Dayna
authors.initials: D
authors.lastname: Greenspoon
authors.forename: Danielle
authors.initials: D
authors.lastname: Levac
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Harper
authors.forename: Mandy
authors.initials: M
authors.lastname: Rubinoff
mesh_terms: D000293:Adolescent; D001924:Brain Concussion / Q000503:physiopathology*; D002648:Child; D003430:Cross-Sectional Studies; D004734:Energy Metabolism; D017079:Exercise Tolerance; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D057240:Patient Preference; D005082:Physical Exertion / Q000502:physiology; D004856:Postural Balance; D020127:Recovery of Function; D056152:Respiratory Rate; D013997:Time Factors; D018910:Video Games
keywords: balance; concussion; exertion; mild traumatic brain injury; pediatrics; virtual reality