POSTER TEMPLATE BY: Effectiveness of Wii Gaming Technology for Children with Down Syndrome Carolyn Little and Genny Tibbs Bellarmine University DPT Program Introduction  Virtual reality (VR) gaming systems are becoming increasingly popular in physical rehabilitation services  VR gaming can foster motor development, spatial awareness, and social interaction  Promotes physical activity with its interactive sports and fitness games  A popular gaming virtual reality system is the Nintendo Wii What is a Wii? 5  Gaming consult that is motion controlled  Sensor activated that encourages active play  Uses a Wii avatar to interact with virtual environment  Variety of games suited for all age groups and fitness level  Popular based on affordability, availability of system and variety of games. Rahman, SA  Randomized Control Trial  30 children with DS randomly assigned to treatment and control groups  Participant met twice a week for six weeks  Control group: traditional physical therapy for 1 hour interventions: strengthening exercises, walking on uneven surfaces, and climbing stairs  Treatment group: same protocol as control group with addition of Wii. A football heading game, tight rope walk game, and Penguin slide game  Results: o Significant improvements in balance both groups (p = 0.000) o Treatment group had a higher p-value between pre and post measures (p =0.000) than control (p = 0.017) Down Syndrome Conclusion Clinical Relevance References  Wii training was found to be a feasible, safe, and beneficial addition to treatment for young children with developmental delays 7  Wii allows the player to practice skills that otherwise could not be fully experienced in a “real world” environment 1  Augmented feedback is known to enhance motor skill learning 6  Multimodal sensory feedback with the avatar can allow children to self-observe and make adjustment while perform task 10  VR systems may be a beneficial supplement to traditional treatment feedback methods 6  Repeated practice of VR games may be accompanied by improvements in balance, postural stability, manual dexterity, and upper limb coordination 1  Future Research Suggestions:  Trials with larger sample sizes  Include participants with wider ranges of intellectual disabilities  Longitudinal studies to assess longevity of results  Gaming systems should not be a replacement for a physical therapy program, instead gaming systems should be used to increase the intensity of exercises and to complement traditional exercises 7  Increases child’s motivation during therapy  Low cost and commercially available gaming system  Potential application of the Wii to home exercise programs  Since adolescents with DS are at higher risk of obesity and sedentary lifestyle physical activity should be encouraged 2 1.Berg P, Becker T, Martian A, Primrose KD, Wingen J. Motor control outcomes following nintendo wii use by a child with down syndrome. Pediatric Physical Therapy. 2012; 24(1): /pep.0b013e31823e05e6. 2.Lin HC, Wuang YP. Strength and agility training in adolescents with down syndrome: a randomized controlled trial. Research in Developmental Disabilities. 2012;33: , 3.Mayo Clinic Staff. Down syndrome. Mayo Clinic. syndrome/DS00182/DSECTION=causes 4.National Down syndrome Society. What is down syndrome? Syndrome/What-Is-Down-Syndrome/ 5.Nintendo Wii. What is Wii? 6.Rahman, SA. Efficacy of virtual reality-based therapy on balance in children with down syndrome. World Applied Sciences Journal. 2010;10(3): ISSN Salem Y, Gropack SJ, Coffin D, Godwin EM. Effectiveness of a low-cost virtual reality system for children with developmental delay: a preliminary randomized single-blind controlled trial. Physiotherapy. 2012; 98 (3): , ISSN , 8.Suzann CK, Robert PJ, Margo ON. Physical therapy for children. 4 th Edition. St. Louis, MO: Elsevier Saunders; Tarantola A. Scientists may have found a genomic off switch for down syndrome. Gizmodo Wuang YP, Chiang CS, Su CY, Wang CC. Effectiveness of virtual reality using Wii gaming technology in children with Down syndrome. Research in Developmental Disabilities. 2011; 32(1): , ISSN , 11.Xu, E. Wii Active – Shape Up Your Body! The Cool Gadgets. shape-up-your-body/  In the US one in every 691 babies is born with Down syndrome 4  Approximately 400,000 Americans have Down syndrome 4  About 6,000 babies with Down syndrome are born in the United States each year 4 What is Down Syndrome? 3  Genetic disorder caused by abnormal cell division of chromosome 21  Congenital disorder that is non-progressive  Varies in severity with developmental delays ranging from moderate to severe  Intellectual and learning disabilities are typically present Common Characteristics of Down Syndrome 8  Problems with postural control and balance  Hypotonia  Hyperflexibility  Delayed gross motor development  Delayed fine motor skills  Requires more time to perform coordinated movements  Better performance with visual than verbal instructions Typical Physical Therapy Interventions  Balance  Core strengthening and postural awareness  General muscle strengthening Evidence Salem Y, Gropack SJ, Coffin D, Godwin EM  Randomized Control Trial  40 children with developmental delay (age 39 to 58 months)  Two 30- minute weekly sessions for 10 weeks  Control group: Individualized traditional rehabilitation focused on movement transitions, balance, walking, and gross and fine motor control  Experimental group: Wii training using Nintendo Wii Sports and Nintendo Wii Fit focused on balance, walking, strength, weight bearing, and aerobics  Results: o Experimental group showed significant improvements in single leg stance test, right grip strength and left grip strength o Although changes in other outcome measures were not significant between the study groups, there were trends towards greater improvements in the experimental group Berg P, Becker T, Martian A, Primrose KD, Wingen J  Case report  8 week intervention conducted at subject’s home  Wii used for at least 4x/week for 20 min/session; Parents asked to keep an activity log  Outcome measures: o Self-Perception Profile for Children (SPPC), Athletic Competence, Physical Appearance subscales, Perceived Physical Ability (PPA), Bruininks-Oseretsky Test of Motor Proficiency, Test of Visual Perceptual Skills, Biodex BioSway Balance System, BodyStat QuadScan 4000  Results: o Improvements in BOT-2 manual dexterity, balance, running speed, and agility scores o Decreased in anterior/posterior sway, increase in medial/lateral sway, overall stability index showed improvement, better dynamic control in all directions except backward and backward right