Effects of Motion Gaming on Physical Activity and Balance Following Physical Rehabilitation in Veterans with Mild Traumatic Brain Injury

Research Objectives: To determine the effect of self-led motion gaming (compared to seated video gaming) on postural stability and amount of physical activity in adult veterans who recently completed physical rehabilitation for TBI-related balance impairment.

Design: A preliminary data analysis of postural sway and activity was completed on data collected as part of an ongoing randomized control trial. The study is an open cohort pre-post RCT intervention 4-weeks of motion gaming self-administered at home.

Setting: Participants were recruited from the Lovell Federal Health Care Center outpatient setting. The study assessments were completed in an academic research laboratory. The intervention and activity assessments were don in the participants' homes.

Participants: 14 adult veterans with mTBI and motor FIM score >4 (6 Control, 8 Intervention condition); There was no significant difference between groups regarding age, height, motor FIM, and weight. Participants (intervention) were aged 41±13 years, 70±4 in, 215±96 lbs.

Interventions: All participants were asked to play a videogame installed by the research staff at their home for 2 hours, twice a week for 4 weeks (Control Group – Mario kart on Wii console; Intervention Group – Table tilt and other mini games on Wii console). Control and intervention conditions received equal amounts of video game play prompts and interaction time, and both conditions received the same pre and post assessments.

Main Outcome Measures: Center of Mass sway pre and post 4 weeks of home gaming (measured with computerized posturography and force plate analysis of static double and single limb postures). Mean sway in the control (n=6) and intervention (n=8) groups was analyzed.
Secondary measure: The feasibility of using wearable sensors was assessed to monitor the amount and type of activity over 7-days prior to the gaming intervention and immediately following the gaming intervention.

Results: Postural stability was maintained after 4 weeks of motion gaming, not in the control condition (Figure). Adherence to the gaming schedule varied widely across participants in both conditions. The wearable sensor data (Figure) indicated good adherence to the wear schedule of all waking hours (except shower/ bathing) over the 7-day periods pre and post intervention.

Conclusions: Motion gaming via low-cost commercial gaming systems may improve or maintain function following rehabilitation after TBI. More research is needed to fully assess the effect of motion gaming at home on center of mass sway. Further research is warranted with larger sample size to study the advantages of motion gaming in mTBI populations of veterans after rehabilitation for mobility is completed.

Author(s) Disclosures: None