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Use of Interactive Gaming for Enhanced Function After Spinal Cord Injury

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01537978
Recruitment Status : Completed
First Posted : February 23, 2012
Last Update Posted : December 10, 2014
Information provided by (Responsible Party):
Beatrice Jenny Kiratli PhD, VA Palo Alto Health Care System

Brief Summary:
The purpose of this study is to evaluate whether there are functional improvements in arm muscles and movments for spinal cord injured indviduals after performing video gaming.

Condition or disease Intervention/treatment Phase
Paraplegia and Tetraplegia Other: Video gaming for enhanced function after spinal cord injury. Phase 1

Detailed Description:

Today, Nintendo's Wii has become integrated into our popular culture replete with its own vocabulary and marketed promise of achieving fitness through video gaming. Recently the term "Wii-habilitation" has gained popularity to represent application of interactive gaming into the therapeutic setting as a form of rehabilitation. However, this technology remains largely untested in the rehabilitation field despite seemingly widespread use.

Interactive gaming may indeed contribute to an important problem in rehabilitation, especially for persons with spinal cord injury (SCI) who use manual wheelchairs for primary mobility and depend on their upper extremity for independence. Individuals with SCI will benefit tremendously by maximization of early rehabilitation post-injury and effective ongoing conditioning focused on the upper extremity through a continuum of care model that supports life-long health habits. Further, traditional exercise therapy targets components of function such as range of motion and strength, but often relies on isolated movements and repetitions which might not be the most effective method. Alternately, video interactive gaming can provide an engaging, variable, challenging, and fun activity-based approach that could enhance both adherence to exercise and functional outcomes.

A video gaming system can be readily implemented in a clinical setting and affordably deployed for home use with minimal instruction, is easy to use for continuation of therapy, and is well-suited to the SCI population for whom exercise options are limited. A wide variety of activities and games are available that utilize upper extremity movements "playing" real world sports such as golf, tennis, and bowling; multiple options for play are available which add variety and contribute to a comprehensive work-out. Players must grade whole upper limb forces to play the various games paralleling a traditional exercise regimen; visual and auditory feedback add interest and fun to the sessions. Interactive gaming allows for single and multiple player options and thus lends itself readily to promotion of social engagement. Real-life scenarios may contribute to self-motivation.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 21 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Use of Interactive Gaming After Spinal Cord Injury
Study Start Date : February 2012
Actual Primary Completion Date : October 2012
Actual Study Completion Date : October 2012

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: Video game play
Changes in upper limb; strength, active range of motion, electromyographic activity as well as heart rate response.
Other: Video gaming for enhanced function after spinal cord injury.
Spinal cord injured indviduals will play Nintendo Wii sports games for an 8 week period.
Other Name: Nintendo Wii Video gaming

Primary Outcome Measures :
  1. Increased Electromyographic actvity of upper the upper arm with video gaming. [ Time Frame: Testing session 1 - at the start of the study ("week 0"). This is called the baseline testing session. ]
    EMG will be measured at baseline testing for video game play and post testing after the videogaming is completed.

Secondary Outcome Measures :
  1. Increased heart rate with Video gaming [ Time Frame: Testing session 1 - at the start of the study ("week 0"). This is called the baseline testing session. ]
    Baseline heart rate will be measured across all video games to see whcih elicit elevated hear rates consistent with appropriate exercise response.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

Neurologic level of injury at or below cervical level 5 (C5) through C8 [tetraplegia] and at or below T1 through L3 [paraplegia]; persons with incomplete lesions at higher levels may be eligible, decided on a case by case basis depending on functional ability, Complete and incomplete injury allowed, Physical capability (ie, sufficient voluntary motor function) to participate in unassisted resistive exercise, determined as a minimum of grade 3 (by manual muscle testing) on elbow and wrist extension, Use of either a manual or power wheelchair as primary mobility, Absence of significant medical complications, Normal or nearly normal cognitive function (ie, minimal cognitive impairment may be allowed on a case by case basis), Willingness to participate for the duration of the study.

Exclusion Criteria:

Use of ambulation for mobility, Concurrently participating in any other exercise intervention or sports program, Medical condition that would interfere in gaming either short term or during extended play.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01537978

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United States, California
Va Palo Alto Health Care System
Palo Alto, California, United States, 94304
Sponsors and Collaborators
VA Palo Alto Health Care System
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Principal Investigator: Beatrice J Kiratli, PhD US Department of Veterans Affairs

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Responsible Party: Beatrice Jenny Kiratli PhD, Director Clinical Research Spinal Cord Injury, VA Palo Alto Health Care System Identifier: NCT01537978     History of Changes
Other Study ID Numbers: 18834
First Posted: February 23, 2012    Key Record Dates
Last Update Posted: December 10, 2014
Last Verified: December 2014
Keywords provided by Beatrice Jenny Kiratli PhD, VA Palo Alto Health Care System:
spinal cord injury, video gaming, functional improvement
Additional relevant MeSH terms:
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Spinal Cord Injuries
Spinal Cord Diseases
Central Nervous System Diseases
Nervous System Diseases
Trauma, Nervous System
Wounds and Injuries
Neurologic Manifestations
Signs and Symptoms