Acceptability of Physical Therapy Combined with Nintendo Ring Fit Adventure Exergame for Geriatric Hospitalized Patients.

Geriatric hospitalized patients often experience complications associated with frailty and impaired functioning in activities of daily living. To enhance their functional independence, repetitive and continuous high-frequency exercises are necessary. However, conventional physical therapy (PT) can be monotonous and lead to reduced adherence. The introduction of Nintendo Ring Fit Adventure exergame (EG) as a complement to PT for geriatric inpatients has the potential to improve exercise enjoyment and acceptability. This study aimed to evaluate the acceptability of combining EG with PT for geriatric inpatients. A total of 30 geriatric inpatients were included in the study, receiving EG+PT on day 1 and PT only on day 2. The rate of perceived exertion (RPE) was assessed using the Borg scale, whereas enjoyment, motivation to continue, and perceived effectiveness were evaluated through a questionnaire after each exercise session and subsequently compared. The RPE for the lower extremities and the sense of enjoyment (P = 0.06) were found to be higher after the EG+PT session. The results suggest that combining PT with EG can enhance the enjoyment of exercise sessions and facilitate an increase in the intensity and frequency of exercise therapy. Incorporating EGs into geriatric PT holds promise as an effective strategy to improve patient engagement and adherence to exercise regimens. Further research is warranted to explore the long-term benefits and potential applications of EGs in geriatric rehabilitation settings.

Safety, feasibility, and acceptability of physiotherapy combined with strength training using active video games for older patients with musculoskeletal conditions.

PURPOSE: This study aimed to determine the safety, feasibility, and acceptability of physiotherapy (PT) combined with strength training using active video games (AVG) for older patients with musculoskeletal conditions. METHODS: Sixteen patients underwent AVG + PT on day 1 and only conventional physiotherapy (CPT) on day 2. The AVG was conducted in 6 upper- and lower-limb training performed in standing position using Ring Fit Adventure (RFA) on Nintendo Switch. Outcome measured adverse events and deviant movements associated with the AVG as safety, execution rate of each AVG programme as feasibility, and questionnaires (4-point Likert scale) regarding enjoyment, motivation to continue, and feeling of efficacy as acceptability. RESULTS: The berg balance scale/functional independence measure indicated 45 ± 8/90 ± 16. No adverse events occurred. Some of deviant movements were observed that could be an injury risk, such as a slight forward movement during the stepping exercise. The execution rate for each AVG programme ranged from 81% to 100%. The categories of enjoyment, motivation to continue, and feeling of efficacy had >90% of positive responses (strongly agree, slightly agree) in AVG + PT, and enjoyment tended to be higher in AVG + PT than in CPT. CONCLUSIONS: Strength training using RFA was considered to be a safe and feasible exercise tool enough to be applicable as part of a rehabilitation programme in older patients with musculoskeletal conditions. However, should be supervised, at least during the introductory phase. It was also positively accepted by older adults, suggesting enhanced enjoyment.IMPLICATIONS FOR REHABILITATIONActive video games (AVG) training with Ring Fit Adventure (RFA) was found to be safe enough to be considered for application as part of a rehabilitation programme for older patients with musculoskeletal conditions, but should be supervised, at least during the introductory phase.AVG training comprising strength training with RFA was found to be a highly feasible exercise tool for rehabilitation in older patients with musculoskeletal conditions.Physiotherapy combined with AVG training using RFA was also well received, suggesting enhanced enjoyment for older patients with musculoskeletal conditions.

Major patterns of plantar flexion resistive torque during the gait cycle in healthy young adults wearing ankle foot orthoses with a plantar flexion stop: a pilot study.

[Purpose] The Gait Judge System measures the plantar flexion resistive torque acting on the angle of the ankle joint, as well as the ankle joint itself, of the ankle-foot orthosis using a 1,000 Hz sampling frequency. This pilot study aimed to determine the characteristics of plantar flexion resistive torque acting on the double Klenzak ankle joint of the ankle-foot orthoses worn by healthy individuals. [Participants and Methods] Participants were eight healthy young adults (3 male, 5 female; mean age, 26.8 years old; mean height, 165 cm.; mean body weight, 56.3 kg). Plantar flexion resistive torques and angles of the ankle joint in gait cycles were measured with the Gait Judge System. Speed of gait was calculated using a ruler attached on the floor and the Gait Judge System video. We classified waveforms according to the existence of second peaks in the gait cycle. The correlations between parameters related to the plantar flexion resistive torque and the speed of gait were evaluated using Pearson's simple correlation analysis. [Results] The plantar flexion resistive torque showed two peaks: the first peak was at the loading response, measured at 17.4 Nm, and the second peak was at the pre-swing phase, measured at 10.9 Nm. However, the second peak was absent in three of the participants. The normalized second peak and the second peak/first peak ratio had a strong, positive correlation with the speed of gait. [Conclusion] The Gait Judge System revealed typical waveforms according to the parameters set in this study.

The Effects of Elbow Bracing on Medial Elbow Joint Space Gapping Associated With Repetitive Throwing in High School Baseball Players.

BACKGROUND: Throwing athletes risk medial elbow injury from extreme valgus stress generated across the medial elbow during throwing. Braces have been developed to protect the elbow joint; however, no previous study has investigated the effects of elbow bracing on medial elbow joint space gapping associated with repetitive throwing. HYPOTHESIS/PURPOSE: The purpose of this study was to investigate the effects of elbow bracing on medial elbow joint space gapping during repetitive throwing. Our hypothesis was that an elbow brace may reduce mechanical stress on the elbow by reducing medial elbow joint space gapping. STUDY DESIGN: Controlled laboratory study. METHODS: Twenty-five high school baseball players participated in this study. Each subject pitched 100 times under 2 conditions: control (without elbow brace) and elbow brace. The ulnohumeral joint space was measured ultrasonically before pitching and after every block of 20 pitches. Measurement of the ulnohumeral joint space was carried out using ultrasound with the forearm hanging by the side. Two-way repeated-measures analysis of variance and post hoc tests were used to compare ulnohumeral joint space with repeated pitching and between the elbow brace and control conditions. RESULTS: In the control condition, ulnohumeral joint space after 60 pitches was significantly greater than that before pitching (P < .01). In contrast, in the elbow brace condition, ulnohumeral joint space was not significantly different after repeated pitching. When comparing these 2 conditions, ulnohumeral joint space in the control condition was significantly greater than that in the elbow brace condition after 60 pitches (P < .01). CONCLUSION: An elbow brace has the effect of preventing medial elbow joint space gapping with repeated throwing when determined ultrasonically by measuring the ulnohumeral joint space under gravity load. CLINICAL RELEVANCE: An elbow brace worn during baseball pitching practice may help reduce mechanical stress on the elbow by reducing medial elbow joint space gapping.