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BackgroundExergaming is a promising new alternative to traditional modes of therapeutic exercise which may be preferable and more effective for people with Multiple Sclerosis (MS). Impaired balance is reported as one of the most disabling aspects of MS. The purposes of this study were to examine the effects of exergaming on: (1) postural sway, (2) gait, (3) technology acceptance and (4) flow experience in people with MS. Secondary outcomes were disability: 12‐item Multiple Sclerosis Walking Scale (MSWS-12) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) questionnaire.MethodsFifty-six adults (mean age = 52 years, SD = 5.8; 38 women) with a clinical diagnosis of MS and able to walk 100 meters with or without use of a walking aid were included in this study and randomized into 3 groups. Group 1 received balance training using the Nintendo Wii Fit™ (exergaming) and Group 2 undertook traditional balance training (non-exergaming). Group 3 acted as a control group, receiving no intervention. Exergaming and traditional balance training groups received four weeks of twice weekly balance-orientated exercise. Postural sway was measured using a Kistler™ force platform. Spatiotemporal parameters of gait were measured using a GAITRite™ computerised walkway. Technology acceptance and flow experience were measured using the Unified Theory of Acceptance and Use of Technology and the Flow State Scale questionnaires, respectively.ResultsThere were significant improvements in bipedal postural sway in both intervention groups when compared to the control group; and no effects of either intervention on gait. There were no significant differences between the interventions in technology acceptance but on several dimensions of flow experience the Wii Fit™ was superior to traditional balance training. Both interventions showed improvements in disability compared to control.ConclusionsIn terms of the physical effects of exergaming, the Wii Fit™ is comparable to traditional balance training. These findings would support the use of the Wii Fit™ as an effective means of balance and gait training for people with MS, which is both accepted and intrinsically motivating to MS users.Trial registrationControlled Trials ISRCTN13924231.

Methods: T2 weighted, sagittal scans of the L1/2 to L5/S1 discs were taken of eleven volunteers in Standing, Upright, Flexed and Extended sitting, Supine and Prone Extension. Sagittal migration of the nucleus pulposus was measured (mm) as distance from anterior disc boundary to peak pixel intensity. Lumbar lordosis in each position was measured using Cobb angle.Results: 15 comparisons between positions showed significant positional effects. 14 at L4/5, L5/S1 the most mobile segments. Prone Extension and Supine lying induced significantly less posterior migration than sitting. Flexed and Upright sitting, significantly more than standing at L4/5, as did Flexed sitting compared to Extended.

BackgroundThe use of exergaming is a potential alternative to traditional methods of balance training, which can be repetitive and somewhat monotonous. The purpose of this study was to assess the effects of exergaming using XBOX Kinect™ versus traditional gym-based exercise with no virtual stimuli (TGB) on postural control, technology acceptance, flow experience and exercise intensity, in young healthy adults.MethodsFifty healthy active adults (age: 33.8 ± 12.7 years, height: 172.9 ± 11.9 cm, weight: 75 ± 15.8 kg) were recruited; 44 completed both baseline and post-intervention data collection. Participants were randomised (blind card) allocation to one of two groups: (1) received balance training using the XBOX Kinect™ and (2) performed traditional gym-based exercise. Exercises were matched for intensity, duration and movement patterns across groups. All participants completed three, 30-minute, exercise sessions a week for four weeks. Postural sway was measured using a Kistler™ Force platform during unipedal standing. Mean heart rate (HR) and rate of perceived exertion (RPE) were collected during each exercise session to determine and verify that intensity of exercise was matched between groups. Technology acceptance was measured with the Unified Theory of Acceptance and Use of Technology (UTAUT) and flow experience with the Flow State Scale (FSS).ResultsHeart rate was matched between groups and BORG RPE was significantly lower in the Kinect™ group. There were significant between-group differences in postural sway in the medial-lateral direction and CoP. There were also significant differences in technology acceptance between groups for performance expectancy, social influence and behavioral intention, with higher values in the Kinect exercise group. The flow state scale showed significant differences between the groups on several dimensions, with higher values in the Kinect exercise group.ConclusionObjective physiological demand of exercise (HR) was matched across groups, but the exergaming group perceived it as being less demanding and of lower intensity. This suggests that exergaming may offer an alternative method of rehabilitation exercise through improved concordance. Balance training in healthy adults using the Kinect is both accepted and intrinsically motivating.Trial registrationRetrospectively registered on 27th July 2016. Trial number NCT02851017.