Original article
Energy Expenditure in Adults With Cerebral Palsy Playing Wii Sports

https://doi.org/10.1016/j.apmr.2010.07.216Get rights and content

Abstract

Hurkmans HL, van den Berg-Emons RJ, Stam HJ. Energy expenditure in adults with cerebral palsy playing Wii Sports.

Objective

To determine energy expenditure of adults with bilateral spastic cerebral palsy while playing Wii Sports tennis and boxing.

Design

Cross-sectional study.

Setting

University medical center.

Participants

Five men and 3 women with bilateral spastic cerebral palsy and ambulatory ability (Gross Motor Function Classification System level I or II) participated. The mean participant age ± SD was 36±7 years. Exclusion criteria were comorbidities that affected daily physical activity and fitness, contraindications to exercise, or inability to understand study instructions owing to cognitive disorders or language barriers.

Intervention

Participants played Wii Sports tennis and boxing, each for 15 minutes in random order.

Main Outcome Measure

By using a portable gas analyzer, we assessed energy expenditure by oxygen uptake (V̇o2) while sitting and during Wii Sports game play. Energy expenditure is expressed in metabolic equivalents (METs), which were calculated as V̇o2 during Wii Sports play divided by V̇o2 during sitting.

Results

Mean ± SD energy expenditure during Wii Sports game play was 4.5±1.1METs for tennis and 5.0±1.1METs for boxing (P=.024). All participants attained energy expenditures greater than 3METs, and 2 participants attained energy expenditures greater than 6METs while playing Wii Sports tennis or boxing.

Conclusions

Both Wii Sports tennis and boxing seem to provide at least moderate-intensity exercise in adults with bilateral spastic cerebral palsy (GMFCS level I or II). These games, therefore, may be useful as treatment to promote more active and healthful lifestyles in these patients. Further research is needed to determine the energy expenditures of other physically disabled patient groups while playing active video games, and to determine the effectiveness of these games in improving health and daily activity levels.

Section snippets

Participants

A convenience sample of 8 persons diagnosed with bilateral spastic CP (GMFCS level I or II),26 and who were ambulatory and able to play Wii Sports when standing without support, participated in the study. Four of the 8 participants exercised on a weekly basis (eg, gym, tennis, or walking). None of the participants was familiar with the Wii before study involvement. These participants were recruited from a cohort of patients with CP (born between January 5, 1959 and January 5, 1979) who had

Results

Participant characteristics and V̇o2 during sitting and standing are summarized in table 1. V̇o2 during sitting was 3.6±0.6 mL · kg−1 · min−1. V̇o2 during standing was 38% greater compared with sitting (1.4 METs; P=.035). Both Wii Sports tennis and boxing increased the V̇o2 above sitting V̇o2 (340% and 393%, respectively; P=.012), and above standing V̇o2 (218% and 256%, respectively; P=.012) (Table 1, Table 2). Energy expenditure during Wii boxing (5.0METs) was higher compared with energy

Discussion

The aim of this study was to determine the energy expenditure during Wii Sports tennis and boxing game play in adults with bilateral spastic CP. To our knowledge, this is the first study to report energy expenditure in people with a chronic physical disability during active video game play. Our results showed that the energy expenditure during Wii Sports tennis and boxing were 4- to 5-fold greater than while sitting.

According to the ACSM guidelines, the energy expenditure for CP participants

Conclusions

Wii Sports tennis and boxing seem to be activities of at least moderate intensity among ambulatory adults with bilateral spastic CP and GMFCS level I or II, and they may be useful as treatment tools to promote active and healthful lifestyles. Future research is needed to investigate the effectiveness of active video games in improving levels of daily activity and health, and to determine whether active video games can be used to improve cardiorespiratory fitness. Future studies should assess

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