Efficacy of Wii Balance Board based Exergame Training among individuals with Cerebellar Ataxia: A Feasibility Study
,
Abstract
BACKGROUND: Conventional rehabilitation methods have shown limited and transient improvements, necessitating personalized approaches in the diverse population of Cerebellar Ataxia. Wii Balance Board exergame training, integrating physical exercise with interactive video games, presents a novel and engaging neuro-rehabilitation strategy.
OBJECTIVES: The primary objective of this study was to assess the clinical feasibility of implementation of Wii Balance Board-based exergame training among individuals with various forms of Cerebellar Ataxia. The secondary objective was to investigate the preliminary efficacy, and assess the enjoyment of the intervention.
METHODS: The study incorporates a pilot randomized control trial and feasibility study design. We recruited 10 patients using a block randomization method. The Wii Balance Board training was administered for 18 sessions, 3 sessions per week, till 6 weeks. The primary outcomes of feasibility testing were evaluated through clinical research log documentation, while secondary outcomes of balance, ataxia severity rate, functional independence and enjoyment were assessed with mini-BESTest, SARA, FIMs and EEQ. Data were analyzed using descriptive statistics and non-parametric tests to evaluate changes in outcomes.
RESULTS: The study enrollment rate was 77% (n=10). The Wii intervention group showed a 100% (n=5) retention rate compared to 80% (n=4) in the control group. The Wii intervention group demonstrated a tendency towards better outcomes at follow-up in SARA (p=0.063, effect size/RM =0.84) and Mini-BESTest (p=0.071, effect size/RM =0.79) but not in the case of FIM (p=0.794, effect size/RM =0.14), along with reported a moderate level of enjoyment.
CONCLUSION: Wii Balance Board based-exergame training is considered feasible for implementation in clinical settings among individuals with various forms of Cerebellar Ataxia, that suggesting the conduction of a larger definitive study to further explore the intervention efficacy.
[1] Manto M, Gandini J, Feil K, Strupp M. Cerebellar ataxias: an update. Curr Opin Neurol 2020;33:150–60. https://doi.org/10.1097/WCO.0000000000000774.
[2] Manto M, Marmolino D. Cerebellar ataxias. Curr Opin Neurol 2009;22:419–29. https://doi.org/10.1097/WCO.0b013e32832b9897.
[3] Rudaks LI, Yeow D, Ng K, Deveson IW, Kennerson ML, Kumar KR. An Update on the Adult-Onset Hereditary Cerebellar Ataxias: Novel Genetic Causes and New Diagnostic Approaches. The Cerebellum 2024. https://doi.org/10.1007/s12311-024-01703-z.
[4] Bhuin S, Biswas S, Roy A, Mukherjee A, Pandit A, Gangopadhyay G. Etiology and course of cerebellar ataxia: A study from Eastern India. Med J Dr Patil Vidyapeeth 2023;16:591. https://doi.org/10.4103/mjdrdypu.mjdrdypu_314_21.
[5] Gorcenco S, Karremo C, Puschmann A. Patients’ Perspective in Hereditary Ataxia. The Cerebellum 2022;23:82–91. https://doi.org/10.1007/s12311-022-01505-1.
[6] Stanley WJ, Kelly CKL, Tung CC, Lok TW, Ringo TMK, Ho YK, et al. Cost of Cerebellar Ataxia in Hong Kong: A Retrospective Cost-of-Illness Analysis. Front Neurol 2020;11:711. https://doi.org/10.3389/fneur.2020.00711.
[7] Lowit A, Greenfield J, Cutting E, Wallis R, Hadjivassiliou M. Symptom burden of people with progressive ataxia, and its wider impact on their friends and relatives: a cross-sectional study. Health Open Res 2021;3:28. https://doi.org/10.12688/amrcopenres.13036.1.
[8] López‐Bastida J, Perestelo‐Pérez L, Montón‐álvarez F, Serrano‐Aguilar P. Social economic costs and health‐related quality of life in patients with degenerative cerebellar ataxia in Spain. Mov Disord 2008;23:212–7. https://doi.org/10.1002/mds.21798.
[9] Milne SC, Roberts M, Williams S, Chua J, Grootendorst AC, Agostinelli G, et al. Goal-Directed Rehabilitation Versus Standard Care for Individuals with Hereditary Cerebellar Ataxia: A Multicenter, Single-Blind, Randomized Controlled Superiority Trial. Ann Neurol n.d.;n/a. https://doi.org/10.1002/ana.27130.
[10] Grobe-Einsler M, Bork F, Faikus A, Hurlemann R, Kaut O. Effects of cerebellar repetitive transcranial magnetic stimulation plus physiotherapy in spinocerebellar ataxias – A randomized clinical trial. CNS Neurosci Ther 2024;30:e14797. https://doi.org/10.1111/cns.14797.
[11] Mitoma H, Manto M, Gandini J. Recent Advances in the Treatment of Cerebellar Disorders. Brain Sci 2020;10:11. https://doi.org/10.3390/brainsci10010011.
[12] Gupta A, Prakash NB, Rahman H. Rehabilitation in Ataxia. Indian J Phys Med Rehabil 2023;33:21–9. https://doi.org/10.4103/ijpmr.ijpmr_42_22.
[13] Ringgenberg N, Mildner S, Hapig M, Hermann S, Kruszewski K, Martin-Niedecken AL, et al. ExerG: adapting an exergame training solution to the needs of older adults using focus group and expert interviews. J NeuroEngineering Rehabil 2022;19:89. https://doi.org/10.1186/s12984-022-01063-x.
[14] Rohof B, Betsch M, Rath B, Tingart M, Quack V. The Nintendo® Wii Fit Balance Board can be used as a portable and low-cost posturography system with good agreement compared to established systems. Eur J Med Res 2020;25:44. https://doi.org/10.1186/s40001-020-00445-y.
[15] Ayvat E, Onursal Kılınç Ö, Ayvat F, Savcun Demirci C, Aksu Yıldırım S, Kurşun O, et al. The Effects of Exergame on Postural Control in Individuals with Ataxia: a Rater-Blinded, Randomized Controlled, Cross-over Study. The Cerebellum 2022;21:64–72. https://doi.org/10.1007/s12311-021-01277-0.
[16] Barbuto S, Martelli D, Isirame O, Lee N, Bishop L, Kuo S, et al. Phase I SINGLE‐BLINDED Randomized Controlled Trial Comparing Balance and Aerobic Training in Degenerative Cerebellar Disease. PM&R 2021;13:364–71. https://doi.org/10.1002/pmrj.12401.
[17] Franzò M, Pica A, Pascucci S, Serrao M, Marinozzi F, Bini F. A Proof of Concept Combined Using Mixed Reality for Personalized Neurorehabilitation of Cerebellar Ataxic Patients. Sensors 2023;23:1680. https://doi.org/10.3390/s23031680.
[18] Winser S, Chan HK, Chen WK, Hau CY, Leung SH, Leung YH, et al. Effects of therapeutic exercise on disease severity, balance, and functional Independence among individuals with cerebellar ataxia: A systematic review with meta-analysis. Physiother Theory Pract 2023;39:1355–75. https://doi.org/10.1080/09593985.2022.2037115.
[19] Pacheco TBF, De Medeiros CSP, De Oliveira VHB, Vieira ER, De Cavalcanti FAC. Effectiveness of exergames for improving mobility and balance in older adults: a systematic review and meta-analysis. Syst Rev 2020;9:163. https://doi.org/10.1186/s13643-020-01421-7.
[20] Pilotto F, Del Bondio A, Puccio H. Hereditary Ataxias: From Bench to Clinic, Where Do We Stand? Cells 2024;13:319. https://doi.org/10.3390/cells13040319.
[21] Paul NW, Mahdiani H. Ethical challenges in clinical studies with adaptive design in oncology. Clin Ethics 2023;18:148–54. https://doi.org/10.1177/14777509221133974.
[22] Eldridge SM, Chan CL, Campbell MJ, Bond CM, Hopewell S, Thabane L, et al. CONSORT 2010 statement: extension to randomised pilot and feasibility trials. BMJ 2016:i5239. https://doi.org/10.1136/bmj.i5239.
[23] Moore CG, Carter RE, Nietert PJ, Stewart PW. Recommendations for Planning Pilot Studies in Clinical and Translational Research. Clin Transl Sci 2011;4:332–7. https://doi.org/10.1111/j.1752-8062.2011.00347.x.
[24] Loudon K, Treweek S, Sullivan F, Donnan P, Thorpe KE, Zwarenstein M. The PRECIS-2 tool: designing trials that are fit for purpose. BMJ 2015;350:h2147–h2147. https://doi.org/10.1136/bmj.h2147.
[25] Darker C, Loudon K, O’Connell N, Castello S, Burke E, Vance J, et al. An application of PRECIS-2 to evaluate trial design in a pilot cluster randomised controlled trial of a community-based smoking cessation intervention for women living in disadvantaged areas of Ireland. Pilot Feasibility Stud 2022;8:19. https://doi.org/10.1186/s40814-022-00969-6.
[26] Miyata K, Kondo Y, Bando K, Hara T, Takahashi Y. Structural validity of the Mini-Balance Evaluation Systems Test in individuals with spinocerebellar ataxia: A Rasch analysis study. Arch Phys Med Rehabil 2024:S0003-9993(24)00032-7. https://doi.org/10.1016/j.apmr.2023.12.015.
[27] Lawerman TF, Brandsma R, Verbeek RJ, Van Der Hoeven JH, Lunsing RJ, Kremer HPH, et al. Construct Validity and Reliability of the SARA Gait and Posture Sub-scale in Early Onset Ataxia. Front Hum Neurosci 2017;11:605. https://doi.org/10.3389/fnhum.2017.00605.
[28] Kim B-R, Lim J-H, Lee SA, Park S, Koh S-E, Lee I-S, et al. Usefulness of the Scale for the Assessment and Rating of Ataxia (SARA) in Ataxic Stroke Patients. Ann Rehabil Med 2011;35:772. https://doi.org/10.5535/arm.2011.35.6.772.
[29] Weyer A, Abele M, Schmitz‐Hübsch T, Schoch B, Frings M, Timmann D, et al. Reliability and validity of the scale for the assessment and rating of ataxia: A study in 64 ataxia patients. Mov Disord 2007;22:1633–7. https://doi.org/10.1002/mds.21544.
[30] Matsugi A. Physical Therapy for Cerebellar Ataxia. In: Suzuki T, editor. Neurol. Phys. Ther., InTech; 2017. https://doi.org/10.5772/67649.
[31] Pilot Studies: Common Uses and Misuses. NCCIH n.d. https://www.nccih.nih.gov/grants/pilot-studies-common-uses-and-misuses (accessed July 16, 2024).
[32] Moulaei K, Sharifi H, Bahaadinbeigy K, Dinari F. Efficacy of virtual reality-based training programs and games on the improvement of cognitive disorders in patients: a systematic review and meta-analysis. BMC Psychiatry 2024;24:116. https://doi.org/10.1186/s12888-024-05563-z.
[33] Nagar A, Vij J, Sulena. OPTIMIZING REHABILITATION STRATEGIES FOR CEREBELLAR ATAXIA IN INDIAN POPULATION : A SYSTEMATIC REVIEW OF PHYSICAL THERAPY INTERVENTIONS. Int J Sci Res 2023;12. https://doi.org/10.36106/ijsr.
[34] Pajaro-Blázquez M, Pons J. Research highlights in neurorehabilitation. J NeuroEngineering Rehabil 2014;11:21. https://doi.org/10.1186/1743-0003-11-21.
[35] Lin C-YR, Kuo S-H, Opal P. Cognitive, Emotional, and Other Non-motor Symptoms of Spinocerebellar Ataxias. Curr Neurol Neurosci Rep 2024. https://doi.org/10.1007/s11910-024-01331-4.
[36] Conner NO, Freeman HR, Jones JA, Luczak T, Carruth D, Knight AC, et al. Virtual Reality Induced Symptoms and Effects: Concerns, Causes, Assessment & Mitigation. Virtual Worlds 2022;1:130–46. https://doi.org/10.3390/virtualworlds1020008.
[37] Dan B. Gamification of therapy: the fun factor in rehabilitation. Dev Med Child Neurol 2022;64:276–276. https://doi.org/10.1111/dmcn.15126.
[38] Alexiou A, Schippers MC. Digital game elements, user experience and learning: A conceptual framework. Educ Inf Technol 2018;23:2545–67. https://doi.org/10.1007/s10639-018-9730-6.
[39] Bonanno M, De Pasquale P, De Marchis C, Lombardo Facciale A, Paladina G, Fonti B, et al. Might patients with cerebellar ataxia benefit from the Computer Assisted Rehabilitation ENvironment (CAREN)? A pilot study focusing on gait and balance. Front Bioeng Biotechnol 2024;12:1385280. https://doi.org/10.3389/fbioe.2024.1385280.
[40] Loomis KJ, Roll SC, Hardison ME. The role of therapist-patient relationships in facilitating engagement and adherence in upper extremity rehabilitation. Work 2023;76:1083–98. https://doi.org/10.3233/WOR-220384.
[41] Marín-Medina DS, Arenas-Vargas PA, Arias-Botero JC, Gómez-Vásquez M, Jaramillo-López MF, Gaspar-Toro JM. New approaches to recovery after stroke. Neurol Sci 2024;45:55–63. https://doi.org/10.1007/s10072-023-07012-3.
[42] Heusel-Gillig LL, Hall CD. Effectiveness of Vestibular Rehabilitation for Patients with Degenerative Cerebellar Ataxia: A Retrospective Cohort Study. Brain Sci 2023;13:1520. https://doi.org/10.3390/brainsci13111520.
[43] Ghazavi Dozin SM, Mohammad Rahimi N, Aminzadeh R. Wii Fit-Based Biofeedback Rehabilitation Among Post-Stroke Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trial. Biol Res Nurs 2024;26:5–20. https://doi.org/10.1177/10998004231180316.
[44] Alves De Souza G. THE BENEFITS OF GAME THERAPY IN NEUROLOGICAL PHYSIOTHERAPEUTIC TREATMENT. Health Soc 2023;3:149–75. https://doi.org/10.51249/hs.v3i03.1365.
[45] Medical center ", Medika Expert", , Ruse, Bulgaria., Andreev A, Mindova S, Department of Public Health, University of Ruse, Bulgaria. ADVANCEMENTS IN VESTIBULAR PHYSIOTHERAPY: A COMPREHENSIVE REVIEW. J IMAB - Annu Proceeding Sci Pap 2024;30:5829–33. https://doi.org/10.5272/jimab.2024304.5829.
[46] Paillard T. The optimal method for improving postural balance in healthy young and older people: specific training for postural tasks encountered in personal physical practice. Front Physiol 2023;14:1188496. https://doi.org/10.3389/fphys.2023.1188496.
[47] Mohammed A Alsultan, Ghalib Abdulah Alghamdi, Abdulkarim Sulaiman Alhumaid. Investigate the Principles and Applications of Task-Specific Training in Neuro-Physiotherapy Rehabilitation. J Adv Sch Res Allied Educ 2024;21:153–8. https://doi.org/10.29070/ms9xcn64.
[48] Afonso M, Sánchez-Cuesta F, González-Zamorano Y, Pablo Romero J, Vourvopoulos A. Investigating the synergistic neuromodulation effect of bilateral rTMS and VR brain-computer interfaces training in chronic stroke patients. J Neural Eng 2024;21:056037. https://doi.org/10.1088/1741-2552/ad8836.
[49] Graciani Z, Moraes ÍAPD, Alberissi CADO, Prado-Rico JM, Silva TDD, Martinez JP, et al. The effect of different interfaces during virtual game practice on motor performance of individuals with genetic ataxia: A cross-sectional study. PLOS ONE 2024;19:e0312705. https://doi.org/10.1371/journal.pone.0312705.
[50] Bonney E, Jelsma LD, Ferguson GD, Smits-Engelsman BCM. Learning better by repetition or variation? Is transfer at odds with task specific training? PLOS ONE 2017;12:e0174214. https://doi.org/10.1371/journal.pone.0174214.
[51] Mlinac ME, Feng MC. Assessment of Activities of Daily Living, Self-Care, and Independence. Arch Clin Neuropsychol 2016;31:506–16. https://doi.org/10.1093/arclin/acw049.
[52] Newell A, Cherry S, Fraser M. Principles of Rehabilitation: Occupational and Physical Therapy. In: Nowicki PD, editor. Orthop. Care Patients Cereb. Palsy, Cham: Springer International Publishing; 2020, p. 221–50. https://doi.org/10.1007/978-3-030-46574-2_11.
[2] Manto M, Marmolino D. Cerebellar ataxias. Curr Opin Neurol 2009;22:419–29. https://doi.org/10.1097/WCO.0b013e32832b9897.
[3] Rudaks LI, Yeow D, Ng K, Deveson IW, Kennerson ML, Kumar KR. An Update on the Adult-Onset Hereditary Cerebellar Ataxias: Novel Genetic Causes and New Diagnostic Approaches. The Cerebellum 2024. https://doi.org/10.1007/s12311-024-01703-z.
[4] Bhuin S, Biswas S, Roy A, Mukherjee A, Pandit A, Gangopadhyay G. Etiology and course of cerebellar ataxia: A study from Eastern India. Med J Dr Patil Vidyapeeth 2023;16:591. https://doi.org/10.4103/mjdrdypu.mjdrdypu_314_21.
[5] Gorcenco S, Karremo C, Puschmann A. Patients’ Perspective in Hereditary Ataxia. The Cerebellum 2022;23:82–91. https://doi.org/10.1007/s12311-022-01505-1.
[6] Stanley WJ, Kelly CKL, Tung CC, Lok TW, Ringo TMK, Ho YK, et al. Cost of Cerebellar Ataxia in Hong Kong: A Retrospective Cost-of-Illness Analysis. Front Neurol 2020;11:711. https://doi.org/10.3389/fneur.2020.00711.
[7] Lowit A, Greenfield J, Cutting E, Wallis R, Hadjivassiliou M. Symptom burden of people with progressive ataxia, and its wider impact on their friends and relatives: a cross-sectional study. Health Open Res 2021;3:28. https://doi.org/10.12688/amrcopenres.13036.1.
[8] López‐Bastida J, Perestelo‐Pérez L, Montón‐álvarez F, Serrano‐Aguilar P. Social economic costs and health‐related quality of life in patients with degenerative cerebellar ataxia in Spain. Mov Disord 2008;23:212–7. https://doi.org/10.1002/mds.21798.
[9] Milne SC, Roberts M, Williams S, Chua J, Grootendorst AC, Agostinelli G, et al. Goal-Directed Rehabilitation Versus Standard Care for Individuals with Hereditary Cerebellar Ataxia: A Multicenter, Single-Blind, Randomized Controlled Superiority Trial. Ann Neurol n.d.;n/a. https://doi.org/10.1002/ana.27130.
[10] Grobe-Einsler M, Bork F, Faikus A, Hurlemann R, Kaut O. Effects of cerebellar repetitive transcranial magnetic stimulation plus physiotherapy in spinocerebellar ataxias – A randomized clinical trial. CNS Neurosci Ther 2024;30:e14797. https://doi.org/10.1111/cns.14797.
[11] Mitoma H, Manto M, Gandini J. Recent Advances in the Treatment of Cerebellar Disorders. Brain Sci 2020;10:11. https://doi.org/10.3390/brainsci10010011.
[12] Gupta A, Prakash NB, Rahman H. Rehabilitation in Ataxia. Indian J Phys Med Rehabil 2023;33:21–9. https://doi.org/10.4103/ijpmr.ijpmr_42_22.
[13] Ringgenberg N, Mildner S, Hapig M, Hermann S, Kruszewski K, Martin-Niedecken AL, et al. ExerG: adapting an exergame training solution to the needs of older adults using focus group and expert interviews. J NeuroEngineering Rehabil 2022;19:89. https://doi.org/10.1186/s12984-022-01063-x.
[14] Rohof B, Betsch M, Rath B, Tingart M, Quack V. The Nintendo® Wii Fit Balance Board can be used as a portable and low-cost posturography system with good agreement compared to established systems. Eur J Med Res 2020;25:44. https://doi.org/10.1186/s40001-020-00445-y.
[15] Ayvat E, Onursal Kılınç Ö, Ayvat F, Savcun Demirci C, Aksu Yıldırım S, Kurşun O, et al. The Effects of Exergame on Postural Control in Individuals with Ataxia: a Rater-Blinded, Randomized Controlled, Cross-over Study. The Cerebellum 2022;21:64–72. https://doi.org/10.1007/s12311-021-01277-0.
[16] Barbuto S, Martelli D, Isirame O, Lee N, Bishop L, Kuo S, et al. Phase I SINGLE‐BLINDED Randomized Controlled Trial Comparing Balance and Aerobic Training in Degenerative Cerebellar Disease. PM&R 2021;13:364–71. https://doi.org/10.1002/pmrj.12401.
[17] Franzò M, Pica A, Pascucci S, Serrao M, Marinozzi F, Bini F. A Proof of Concept Combined Using Mixed Reality for Personalized Neurorehabilitation of Cerebellar Ataxic Patients. Sensors 2023;23:1680. https://doi.org/10.3390/s23031680.
[18] Winser S, Chan HK, Chen WK, Hau CY, Leung SH, Leung YH, et al. Effects of therapeutic exercise on disease severity, balance, and functional Independence among individuals with cerebellar ataxia: A systematic review with meta-analysis. Physiother Theory Pract 2023;39:1355–75. https://doi.org/10.1080/09593985.2022.2037115.
[19] Pacheco TBF, De Medeiros CSP, De Oliveira VHB, Vieira ER, De Cavalcanti FAC. Effectiveness of exergames for improving mobility and balance in older adults: a systematic review and meta-analysis. Syst Rev 2020;9:163. https://doi.org/10.1186/s13643-020-01421-7.
[20] Pilotto F, Del Bondio A, Puccio H. Hereditary Ataxias: From Bench to Clinic, Where Do We Stand? Cells 2024;13:319. https://doi.org/10.3390/cells13040319.
[21] Paul NW, Mahdiani H. Ethical challenges in clinical studies with adaptive design in oncology. Clin Ethics 2023;18:148–54. https://doi.org/10.1177/14777509221133974.
[22] Eldridge SM, Chan CL, Campbell MJ, Bond CM, Hopewell S, Thabane L, et al. CONSORT 2010 statement: extension to randomised pilot and feasibility trials. BMJ 2016:i5239. https://doi.org/10.1136/bmj.i5239.
[23] Moore CG, Carter RE, Nietert PJ, Stewart PW. Recommendations for Planning Pilot Studies in Clinical and Translational Research. Clin Transl Sci 2011;4:332–7. https://doi.org/10.1111/j.1752-8062.2011.00347.x.
[24] Loudon K, Treweek S, Sullivan F, Donnan P, Thorpe KE, Zwarenstein M. The PRECIS-2 tool: designing trials that are fit for purpose. BMJ 2015;350:h2147–h2147. https://doi.org/10.1136/bmj.h2147.
[25] Darker C, Loudon K, O’Connell N, Castello S, Burke E, Vance J, et al. An application of PRECIS-2 to evaluate trial design in a pilot cluster randomised controlled trial of a community-based smoking cessation intervention for women living in disadvantaged areas of Ireland. Pilot Feasibility Stud 2022;8:19. https://doi.org/10.1186/s40814-022-00969-6.
[26] Miyata K, Kondo Y, Bando K, Hara T, Takahashi Y. Structural validity of the Mini-Balance Evaluation Systems Test in individuals with spinocerebellar ataxia: A Rasch analysis study. Arch Phys Med Rehabil 2024:S0003-9993(24)00032-7. https://doi.org/10.1016/j.apmr.2023.12.015.
[27] Lawerman TF, Brandsma R, Verbeek RJ, Van Der Hoeven JH, Lunsing RJ, Kremer HPH, et al. Construct Validity and Reliability of the SARA Gait and Posture Sub-scale in Early Onset Ataxia. Front Hum Neurosci 2017;11:605. https://doi.org/10.3389/fnhum.2017.00605.
[28] Kim B-R, Lim J-H, Lee SA, Park S, Koh S-E, Lee I-S, et al. Usefulness of the Scale for the Assessment and Rating of Ataxia (SARA) in Ataxic Stroke Patients. Ann Rehabil Med 2011;35:772. https://doi.org/10.5535/arm.2011.35.6.772.
[29] Weyer A, Abele M, Schmitz‐Hübsch T, Schoch B, Frings M, Timmann D, et al. Reliability and validity of the scale for the assessment and rating of ataxia: A study in 64 ataxia patients. Mov Disord 2007;22:1633–7. https://doi.org/10.1002/mds.21544.
[30] Matsugi A. Physical Therapy for Cerebellar Ataxia. In: Suzuki T, editor. Neurol. Phys. Ther., InTech; 2017. https://doi.org/10.5772/67649.
[31] Pilot Studies: Common Uses and Misuses. NCCIH n.d. https://www.nccih.nih.gov/grants/pilot-studies-common-uses-and-misuses (accessed July 16, 2024).
[32] Moulaei K, Sharifi H, Bahaadinbeigy K, Dinari F. Efficacy of virtual reality-based training programs and games on the improvement of cognitive disorders in patients: a systematic review and meta-analysis. BMC Psychiatry 2024;24:116. https://doi.org/10.1186/s12888-024-05563-z.
[33] Nagar A, Vij J, Sulena. OPTIMIZING REHABILITATION STRATEGIES FOR CEREBELLAR ATAXIA IN INDIAN POPULATION : A SYSTEMATIC REVIEW OF PHYSICAL THERAPY INTERVENTIONS. Int J Sci Res 2023;12. https://doi.org/10.36106/ijsr.
[34] Pajaro-Blázquez M, Pons J. Research highlights in neurorehabilitation. J NeuroEngineering Rehabil 2014;11:21. https://doi.org/10.1186/1743-0003-11-21.
[35] Lin C-YR, Kuo S-H, Opal P. Cognitive, Emotional, and Other Non-motor Symptoms of Spinocerebellar Ataxias. Curr Neurol Neurosci Rep 2024. https://doi.org/10.1007/s11910-024-01331-4.
[36] Conner NO, Freeman HR, Jones JA, Luczak T, Carruth D, Knight AC, et al. Virtual Reality Induced Symptoms and Effects: Concerns, Causes, Assessment & Mitigation. Virtual Worlds 2022;1:130–46. https://doi.org/10.3390/virtualworlds1020008.
[37] Dan B. Gamification of therapy: the fun factor in rehabilitation. Dev Med Child Neurol 2022;64:276–276. https://doi.org/10.1111/dmcn.15126.
[38] Alexiou A, Schippers MC. Digital game elements, user experience and learning: A conceptual framework. Educ Inf Technol 2018;23:2545–67. https://doi.org/10.1007/s10639-018-9730-6.
[39] Bonanno M, De Pasquale P, De Marchis C, Lombardo Facciale A, Paladina G, Fonti B, et al. Might patients with cerebellar ataxia benefit from the Computer Assisted Rehabilitation ENvironment (CAREN)? A pilot study focusing on gait and balance. Front Bioeng Biotechnol 2024;12:1385280. https://doi.org/10.3389/fbioe.2024.1385280.
[40] Loomis KJ, Roll SC, Hardison ME. The role of therapist-patient relationships in facilitating engagement and adherence in upper extremity rehabilitation. Work 2023;76:1083–98. https://doi.org/10.3233/WOR-220384.
[41] Marín-Medina DS, Arenas-Vargas PA, Arias-Botero JC, Gómez-Vásquez M, Jaramillo-López MF, Gaspar-Toro JM. New approaches to recovery after stroke. Neurol Sci 2024;45:55–63. https://doi.org/10.1007/s10072-023-07012-3.
[42] Heusel-Gillig LL, Hall CD. Effectiveness of Vestibular Rehabilitation for Patients with Degenerative Cerebellar Ataxia: A Retrospective Cohort Study. Brain Sci 2023;13:1520. https://doi.org/10.3390/brainsci13111520.
[43] Ghazavi Dozin SM, Mohammad Rahimi N, Aminzadeh R. Wii Fit-Based Biofeedback Rehabilitation Among Post-Stroke Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trial. Biol Res Nurs 2024;26:5–20. https://doi.org/10.1177/10998004231180316.
[44] Alves De Souza G. THE BENEFITS OF GAME THERAPY IN NEUROLOGICAL PHYSIOTHERAPEUTIC TREATMENT. Health Soc 2023;3:149–75. https://doi.org/10.51249/hs.v3i03.1365.
[45] Medical center ", Medika Expert", , Ruse, Bulgaria., Andreev A, Mindova S, Department of Public Health, University of Ruse, Bulgaria. ADVANCEMENTS IN VESTIBULAR PHYSIOTHERAPY: A COMPREHENSIVE REVIEW. J IMAB - Annu Proceeding Sci Pap 2024;30:5829–33. https://doi.org/10.5272/jimab.2024304.5829.
[46] Paillard T. The optimal method for improving postural balance in healthy young and older people: specific training for postural tasks encountered in personal physical practice. Front Physiol 2023;14:1188496. https://doi.org/10.3389/fphys.2023.1188496.
[47] Mohammed A Alsultan, Ghalib Abdulah Alghamdi, Abdulkarim Sulaiman Alhumaid. Investigate the Principles and Applications of Task-Specific Training in Neuro-Physiotherapy Rehabilitation. J Adv Sch Res Allied Educ 2024;21:153–8. https://doi.org/10.29070/ms9xcn64.
[48] Afonso M, Sánchez-Cuesta F, González-Zamorano Y, Pablo Romero J, Vourvopoulos A. Investigating the synergistic neuromodulation effect of bilateral rTMS and VR brain-computer interfaces training in chronic stroke patients. J Neural Eng 2024;21:056037. https://doi.org/10.1088/1741-2552/ad8836.
[49] Graciani Z, Moraes ÍAPD, Alberissi CADO, Prado-Rico JM, Silva TDD, Martinez JP, et al. The effect of different interfaces during virtual game practice on motor performance of individuals with genetic ataxia: A cross-sectional study. PLOS ONE 2024;19:e0312705. https://doi.org/10.1371/journal.pone.0312705.
[50] Bonney E, Jelsma LD, Ferguson GD, Smits-Engelsman BCM. Learning better by repetition or variation? Is transfer at odds with task specific training? PLOS ONE 2017;12:e0174214. https://doi.org/10.1371/journal.pone.0174214.
[51] Mlinac ME, Feng MC. Assessment of Activities of Daily Living, Self-Care, and Independence. Arch Clin Neuropsychol 2016;31:506–16. https://doi.org/10.1093/arclin/acw049.
[52] Newell A, Cherry S, Fraser M. Principles of Rehabilitation: Occupational and Physical Therapy. In: Nowicki PD, editor. Orthop. Care Patients Cereb. Palsy, Cham: Springer International Publishing; 2020, p. 221–50. https://doi.org/10.1007/978-3-030-46574-2_11.
| Files | ||
| Issue | Articles in Press | |
| Section | Articles | |
| Keywords | ||
| Balance Cerebellar Ataxia Exergames Virtual Reality rehabilitation Wii Balance Board. | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Pratihar S, Rajasekaran K, Parasuraman SP. Efficacy of Wii Balance Board based Exergame Training among individuals with Cerebellar Ataxia: A Feasibility Study. Health Tech Ass Act. 2025;.
