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  • PTJ: Research on Computer Gaming's Effectiveness in Physical Therapy Needs to Level Up

    Playing active computer games (ACGs) may increase older adults’ physical activity, but authors of a recent article published in Physical Therapy (PTJ) say that current data provide "little confidence" that such activity improves physical health or cognition. And it’s not yet clear whether it is safe for older adults to play ACGs unsupervised.

    Active computer gaming such as Nintendo Wii or Microsoft’s Xbox is being used in rehabilitation based in part on an assumption that sounds reasonable enough: because the games are fun and motivating, adherence to physical therapist interventions will improve, which will in turn have an impact on health outcomes such as falls. Authors of the PTJ review wanted to know if that assumption was supported by data.

    Authors analyzed 35 randomized controlled trials with 1,838 total participants to determine whether ACG improved balance, functional exercise capacity, functional mobility, fear of falling, and cognition. They also examined participant adherence to interventions and factors such as dose, frequency, setting, and whether interventions were supervised.

    What they found: playing ACGs had a "significant moderate effect" on cognition and balance, and on functional exercise capacity when participants played more than 120 minutes per week. But ACG had no effect on functional mobility or fear of falling. Researchers interpret the findings with caution, as all of the studies were low or very low quality.

    The fact that ACG had a moderate effect "on one outcome associated with falls risk yet no effect on another…highlights the importance of tailoring ACG interventions to older adults’ specific needs for daily function," authors write. The ACG interventions employed a variety of mechanisms to improve function, they explain, and facing forward while standing in one spot may have helped participants improve balance but not functional mobility.

    Authors also raise safety as an issue for ACGs, which they say hold "promise for self-led exercise interventions for even the most frail." But determining which ACGs are safe to use unsupervised was impossible to determine, as only 3 studies used unsupervised interventions. Further, only 9 studies included individuals with balance impairments—making them less likely to be unable to engage in traditional exercise. This makes it difficult to evaluate effects of ACG for this population, authors say.

    "Findings of this review suggest that ACG may provide positive physical and cognitive health benefits greater than those observed following no treatment, traditional exercise, or rehabilitation interventions for balance, functional exercise capacity, and cognitive function," authors conclude, but higher-quality, "robust" randomized controlled trials are needed "in order to state with confidence" that ACG is effective.

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.

    Government Affairs and Public Service Awards Nominations Due January 12, 2018

    Do you know of an APTA member who in 2017 has gone above and beyond to advocate on behalf of the physical therapy profession at the federal level? Is there a member of Congress, staffer, or public figure who has championed physical therapy causes this year? Nominate them for APTA’s Federal Government Affairs Leadership Award or the Public Service Award.

    The Federal Government Affairs Leadership Award is presented annually to an active APTA member who has made significant contributions to the association’s federal government affairs efforts and shown exemplary leadership in furthering the association's objectives in the federal arena.

    The Public Service Award is presented annually to an individual who has demonstrated distinctive support for the physical therapy profession at a national level. Individuals from the following categories are eligible for nomination: members of Congress, congressional staff, federal agency officials, health and legislative association staff, and celebrities or other public figures.

    Recipients will be selected in February by the APTA Board of Directors, and the awards will be presented during APTA's Federal Advocacy Forum set for April 29–May 1 in Washington, DC. Winners' expenses to attend the award event will be paid by APTA.

    Nominations must be submitted by Friday, January 12, to Jennica Sims at jennicasims@apta.org.