Mii-vitaliSe: a pilot randomised controlled trial of a home gaming system (Nintendo Wii) to increase activity levels, vitality and well-being in people with multiple sclerosis

Abstract

ObjectivesWhile the health and well-being benefits of physical activity are recognised, people with multiple sclerosis (MS) often face greater barriers than the general population. The Nintendo Wii potentially offers a fun, convenient way of overcoming some of these. The aim was to test the feasibility of conducting a definitive trial of the effectiveness and cost-effectiveness of Mii-vitaliSe; a home-based, physiotherapist-supported Nintendo Wii intervention.DesignA single-centre wait-list randomised controlled study.SettingMS service in secondary care.ParticipantsAmbulatory, relatively inactive people with clinically confirmed MS.InterventionThirty participants were randomised to receive Mii-vitaliSe either immediately (for 12 months) or after a 6-month wait (for 6 months). Mii-vitaliSe consisted of two supervised Nintendo Wii familiarisation sessions in the hospital followed by home use (Wii Sports, Sports Resort and Fit Plus software) with physiotherapist support and personalised resources.OutcomesIncluded self-reported physical activity levels, quality of life, mood, self-efficacy, fatigue and assessments of balance, gait, mobility and hand dexterity at baseline, 6 and 12 months. Interviews (n=25) explored participants’ experiences and, at study end, the two Mii-vitaliSe facilitators’ experiences of intervention delivery (main qualitative findings reported separately).ResultsMean (SD) age was 49.3 (8.7) years, 90% female, with 47% diagnosed with MS <6 years ago and 60% new to active gaming. The recruitment rate was 31% (95% CI 20% to 44%). Outcome data were available for 29 (97%) at 6 months and 28 (93%) at 12 months. No serious adverse events were reported during the study. Qualitative data indicated that Mii-vitaliSe was well-received. Mean Wii use across both groups over the initial 6-month intervention period was twice a week for 27 min/day. Mean cost of delivering Mii-vitaliSe was £684 per person.DiscussionMii-vitaliSe appears acceptable and a future trial feasible and warranted. These findings will inform its design.Trial registrationISRCTN49286846

The effects of exergames on anxiety levels: A systematic review and meta‐analysis

“…Adherence was reported in two different ways: as dropout rates and/or as proportion of sessions/days completed. With respect to dropouts, only three studies 47,53,60 did not lose any participants, while six studies lost between 2.0% and 8.4%, 18,49,51,56‐57,59 three studies lost 12.7%‐17.9%, 55,58,61 one study lost 26.2%, 48 one study lost 28.3%, 50 and one study lost 43.8% 54 of the participants. When considering the proportion of intervention sessions/days attended by the participants, only seven studies reported data, 50‐51,54‐56,60,61 with attendance rates to the exergame intervention being ~30%, 56 62%, 54 63.9%, 60 ~77%, 50,55 and ~84% 51,61 .…”

“…The number of participants in the studies varied from 15 60 to 88 52 . Two studies examined exclusively men, 47,50 three exclusively women, 32,51,60 while 11 studies assessed a mixed sex sample 18,48‐49,52‐56,58‐59,61 and one study did not report the participants’ sex 57 . In total, 236 men and 297 women participated in the included studies.…”

“…Only one study evaluated healthy young individuals 32 and other older adults 52 . The remaining 15 studies investigated participants with some type of disease 18,47‐51,53‐61 …”

“…The weekly frequency of exergame sessions for chronic studies ranged from two 47,49,51,56 to seven 18 with the most common frequencies being two 47,49,51,56 and three times per week 50,59‐61 . Session duration ranged from 10 minutes 60 to 86 minutes 50 .…”

“…Supplementary Material shows additional information about the study quality of the included studies. Among the randomized trials included in the risk of bias assessment, five studies used blind assessors 49,55‐56,59 . Three studies did not blind participants and personnel, 48,56,57 and this information was unclear in the others randomized trials assessed.…”