Use of commercial video games to improve postural balance in patients with multiple sclerosis:a systematic review and meta-analysis of randomised controlled clinical trials.

INTRODUCTION: Commercial video games are considered an effective tool to improve postural balance in different populations. However, the effectiveness of these video games for patients with multiple sclerosis (MS) is unclear. OBJECTIVES: To analyse existing evidence on the effects of commercial video games on postural balance in patients with MS. MATERIAL AND METHOD: We conducted a systematic literature search on 11 databases (Academic-Search Complete, AMED, CENTRAL, CINAHL, WoS, IBECS, LILACS, Pubmed/Medline, Scielo, SPORTDiscus, and Science Direct) using the following terms: "multiple sclerosis", videogames, "video games", exergam*, "postural balance", posturography, "postural control", balance. Risk of bias was analysed by 2 independent reviewers. We conducted 3 fixed effect meta-analyses and calculated the difference of means (DM) and the 95% confidence interval (95% CI) for the Four Step Square Test, Timed 25-Foot Walk, and Berg Balance Scale (BBS). RESULTS: Five randomised controlled trials were included in the qualitative systematic review and 4 in the meta-analysis. We found no significant differences between the video game therapy group and the control group in Four Step Square Test (DM: -.74; 95% CI, -2.79 to 1.32; P=.48; I2=0%) and Timed 25-Foot Walk scores (DM: .15; 95% CI, -1.06 to .76; P=.75; I2=0%). We did observe intergroup differences in BBS scores in favour of video game therapy (DM: 5.30; 95% CI, 3.39-7.21; P<.001; I2=0%), but these were not greater than the minimum detectable change reported in the literature. CONCLUSIONS: The effectiveness of commercial video game therapy for improving postural balance in patients with MS is limited.

Efectos de la terapia con videojuegos comerciales sobre el equilibrio postural en pacientes con esclerosis múltiple: revisión sistemática y metaanálisis de ensayos clínicos controlados aleatorizados / Use of commercial video games to improve postural balance in patients with multiple sclerosis: A systematic review and meta-analysis of randomised controlled clinical trials

Introducción: El uso de videojuegos comerciales ha sido considerado una herramienta eficaz para mejorar el equilibrio postural en diferentes poblaciones. Sin embargo, los beneficios reportados en pacientes con esclerosis múltiple (PEM) no están claros.ObjetivosAnalizar la evidencia existente sobre los efectos de las terapias con videojuegos comerciales en el equilibrio postural en PEM.Material y métodoSe realizó una búsqueda en las bases de datos Academic-Search-Complete, AMED, CENTRAL, CINAHL, WoS, IBECS, LILACS, Pubmed/Medline, Scielo, SPORTDiscus, ScienceDirect utilizando los términos multiple sclerosis, videogames, video games, exergam*, postural balance, posturography, postural control, balance. El riesgo de sesgo fue analizado por 2 revisores independientes. Se realizaron 3 metaanálisis modelos de efectos fijos calculando la diferencia de medias (DM) y el intervalo de confianza (IC) del 95% para las variables Four-Step-Square-Test, Timed-25-Foot-Walk y Berg-Balance-Scale.ResultadosCinco ensayos clínicos controlados aleatorizados fueron incluidos en la síntesis cualitativa, mientras que 4 fueron incluidos en el metaanálisis. No se observaron diferencias entre las terapias con videojuegos y los grupos controles para la variable Four-Step-Square-Test (DM: –0,74; IC 95%: –2,79 a 1,32; p = 0,48; I2 = 0%) y Timed-25-Foot-Walk (DM: –0,15; IC 95%: –1,06 a 0,76; p = 0,75; I2 = 0%). Sin embargo, la variable Berg-Balance-Scale mostró diferencias a favor del grupo de videojuegos (DM: 5,30; IC 95%: 3,39 a 7,21; p < 0,001; I2 = 0%), aunque estos resultados no fueron superiores al mínimo cambio detectable reportado en la literatura científica.ConclusionesLa eficacia de las terapias con videojuegos comerciales sobre el equilibrio postural en PEM es escasa. (AU)

Introduction: Commercial video games are considered an effective tool to improve postural balance in different populations. However, the effectiveness of these video games for patients with multiple sclerosis (MS) is unclear.ObjectivesTo analyse existing evidence on the effects of commercial video games on postural balance in patients with MS.Material and methodWe conducted a systematic literature search on 11 databases (Academic-Search Complete, AMED, CENTRAL, CINAHL, WoS, IBECS, LILACS, Pubmed/Medline, Scielo, SPORTDiscus, and Science Direct) using the following terms: “multiple sclerosis”, videogames, “video games”, exergam*, “postural balance”, posturography, “postural control”, balance. Risk of bias was analysed by 2 independent reviewers. We conducted 3 fixed effect meta-analyses and calculated the difference of means (DM) and the 95% confidence interval (95% CI) for the Four Step Square Test, Timed 25-Foot Walk, and Berg Balance Scale.ResultsFive randomized controlled trials were included in the qualitative systematic review and 4 in the meta-analysis. We found no significant differences between the video game therapy group and the control group in Four Step Square Test (DM: –.74; 95% CI, –2.79-1.32; P = .48; I2 = 0%) and Timed 25-Foot Walk scores (DM: .15; 95% CI, –1.06-.76; P = .75; I2 = 0%). We did observe intergroup differences in BBS scores in favour of video game therapy (DM: 5.30; 95% CI, 3.39-7.21; P < .001; I2 = 0%), but these were not greater than the minimum detectable change reported in the literature.ConclusionsThe effectiveness of commercial video game therapy for improving postural balance in patients with MS is limited. (AU)

Use of commercial video games to improve postural balance in patients with multiple sclerosis: A systematic review and meta-analysis of randomised controlled clinical trials. / Efectos de la terapia con videojuegos comerciales sobre el equilibrio postural en pacientes con esclerosis múltiple: revisión sistemática y metaanálisis de ensayos clínicos controlados aleatorizados.

INTRODUCTION: Commercial video games are considered an effective tool to improve postural balance in different populations. However, the effectiveness of these video games for patients with multiple sclerosis (MS) is unclear. OBJECTIVES: To analyse existing evidence on the effects of commercial video games on postural balance in patients with MS. MATERIAL AND METHOD: We conducted a systematic literature search on 11 databases (Academic-Search Complete, AMED, CENTRAL, CINAHL, WoS, IBECS, LILACS, Pubmed/Medline, Scielo, SPORTDiscus, and Science Direct) using the following terms: "multiple sclerosis", videogames, "video games", exergam*, "postural balance", posturography, "postural control", balance. Risk of bias was analysed by 2 independent reviewers. We conducted 3 fixed effect meta-analyses and calculated the difference of means (DM) and the 95% confidence interval (95% CI) for the Four Step Square Test, Timed 25-Foot Walk, and Berg Balance Scale. RESULTS: Five randomized controlled trials were included in the qualitative systematic review and 4 in the meta-analysis. We found no significant differences between the video game therapy group and the control group in Four Step Square Test (DM: -.74; 95% CI, -2.79-1.32; P=.48; I2=0%) and Timed 25-Foot Walk scores (DM: .15; 95% CI, -1.06-.76; P=.75; I2=0%). We did observe intergroup differences in BBS scores in favour of video game therapy (DM: 5.30; 95% CI, 3.39-7.21; P<.001; I2=0%), but these were not greater than the minimum detectable change reported in the literature. CONCLUSIONS: The effectiveness of commercial video game therapy for improving postural balance in patients with MS is limited.

Relationship between jumping abilities and skeletal muscle architecture of lower limbs in humans: Systematic review and meta-analysis.

The aim of this study was to examine the influence of skeletal muscle architecture (SMA) features measured by 2-D ultrasonography on jumping performance in humans. A systematic review and meta-analysis was conducted, registry number: CRD42016043602. The scientific literature was systematically searched in eight databases, last run on March 14th, 2017. Cross-sectional studies focused on the association between SMA features and vertical jumping performance were selected. A random-effects model was used to analyze the influence of lower-limb SMA and maximal jump height. A total of 11 studies were included in the qualitative synthesis and 6 studies were selected for meta-analysis. 250 correlations were reviewed across studies. The vast majority were either not statistically significant (185; 74%), weak or very weak (169; 68%) for different jump modalities; counter-movement jump (CMJ), squat jump (SJ), and drop jump. There was insufficient data to perform meta-analysis on muscles other than vastus lateralis for CMJ and SJ. The meta-analyses did not yield any significant association between vastus lateralis SMA and SJ height. Only a significant overall association was shown between vastus lateralis thickness and CMJ height (summary-r = 0.28; 95% confidence interval (CI) = -0.05 to 0.48; p = .059) for a 90% CI level. No differences were found between summary-r coefficients for SMA parameters and jump height during both jumps (CMJ: χ2 = 2.43; df   = 2; p = .30; SJ: χ2 = 0.45; df = 2; p = .80) with a low heterogeneity ratio. Current evidence does not suggest a great influence of lower-limb SMA on vertical jumping performance in humans.

Bilateral deficit in explosive force related to sit-to-stand performance in older postmenopausal women.

The purpose of this study was to determine whether the bilateral deficit (BLD) for maximal voluntary force (MVF) and rate of force development (RFD) influences sit-to-stand in older postmenopausal women. Fourteen women performed unilateral and bilateral maximal voluntary contractions during isometric leg-extension. The MVF and RFD over consecutive 50ms periods (0-50, 50-100 and 100-150ms) after force onset and the time to sit-to-stand test were calculated. There was only a BLD for RFD 0-50ms and 50-100ms. The time of sit-to-stand was moderately correlated to BLD for RFD 0-50ms (r=0.505; 95% CI: -0.035 to 0.817; P=0.06), but after controlling for physical activity level the relationship was stronger and statistically significant (r=0.605; 95% CI: 0.109 to 0.859; P=0.029). These results suggest that the BLD for explosive force (0-50ms) might represent a performance-limiting factor for sit-to-stand transfer in postmenopausal women and could be dependent of the physical activity level. Trial registered at Clinical Trials Gov.: NCT02434185.