title: Physiological response during activity programs using Wii-based video games in patients with cystic fibrosis (CF).
abstract: Patients with cystic fibrosis (CF) are characterized by an abnormal ventilation response that limits the exercise capacity. Exercise training increases exercise capacity, decreases dyspnea and improves health-related quality of life in CF. Adherence to pulmonary rehabilitation programs is a key factor to guarantee optimal benefits and a difficult goal in this population. The aim of this study was to determine the physiological response during three Nintendo Wii™ video game activities (VGA) candidates to be used as training modalities in patients with CF.
  
  
  METHODS
  24 CF patients (age 12.6±3.7 years; BMI 18.8±2.9kgm(-2); FEV1 93.8±18.8%pred) were included. All participants performed, on two separate days, 3 different VGA: 1) Wii Fit Plus (Wii-Fit); 2) Wii Active (Wii-Acti), and 3) Wii Family Trainer (Wii-Train), in random order during 5min. The obtained results were compared with the 6-min walk test (6MWT). The physiological variables [oxygen uptake (VO2), minute ventilation (VE), and heart rate (HR)] were recorded using a portable metabolic analyzer.
  
  
  RESULTS
  During all VGA and 6MWT, VO2 reached a plateau from the 3rd min. Compared with the 6MWT (1024.2±282.2mLm(-1)), Wii-Acti (1232.2±427.2mLm(-1)) and Wii-Train (1252.6±360.2mLm(-1)) reached higher VO2 levels during the last 3min (p<0.0001 in both cases), while Wii-Fit (553.8±113.2mLm(-1)) reached significantly lower levels of VO2 (p<0.001). Similar effects were seen for the ventilatory volume (VE). No differences in dyspnea and oxygen saturation were seen between the different modalities. All patients were compliant with all three Wii™ modalities.
  
  
  CONCLUSIONS
  Active video game are well tolerated by patients with CF. All the modalities evaluated imposed a constant load but were associated with different physiological responses reflecting the different intensities imposed. Wii-Acti and Wii-Train impose a significantly high metabolic demand comparable to the 6MWT. Further research is needed to evaluate the effects of VGA as a training program to increase exercise capacity for CF patients.
authors.affiliation: Asociación Madrileña de Fibrosis Quística, Center for Advanced Studies, University La Salle, University Autonoma of Madrid, Madrid, Spain; Master Respiratory Medicine, Barcelona University and Pompeu Fabra University, Barcelona, Spain.
authors.forename: Tamara
authors.initials: T
authors.lastname: del Corral
authors.affiliation: Master Respiratory Medicine, Barcelona University and Pompeu Fabra University, Barcelona, Spain.
authors.forename: Janaína
authors.initials: J
authors.lastname: Percegona
authors.affiliation: Master Respiratory Medicine, Barcelona University and Pompeu Fabra University, Barcelona, Spain.
authors.forename: Melisa
authors.initials: M
authors.lastname: Seborga
authors.affiliation: ELEGI/Colt Laboratory, UoE/MRC Centre for Inflammation Research, The Queen's Medical Research Institute Edinburgh, UK.
authors.forename: Roberto A
authors.initials: RA
authors.lastname: Rabinovich
authors.affiliation: Blanquerna Health Science Faculty, Physiotherapy Research Group (GReFis), Ramon Llull University, Barcelona, Spain. Electronic address: jordivc@blanquerna.url.edu.
authors.forename: Jordi
authors.initials: J
authors.lastname: Vilaró
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D003550:Cystic Fibrosis / Q000503:physiopathology* / Q000534:rehabilitation*; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D005541:Forced Expiratory Volume; D006339:Heart Rate; D006801:Humans; D008297:Male; D010101:Oxygen Consumption; D005082:Physical Exertion; D018910:Video Games
keywords: Exercise capacity; Physiological response and cystic fibrosis; Pulmonary rehabilitation; Video games