Upper limb muscle activation during sports video gaming of persons with spinal cord injury

Abstract

Objective

Video gaming as a therapeutic tool has largely been studied within the stroke population with some benefits reported in upper limb motor performance, balance, coordination, and cardiovascular status. To date, muscle activation of upper limb muscles in persons with spinal cord injuries (SCI) has not been studied during video game play. In this paper, we provide descriptive and comparative data for muscle activation and strength during gaming for players with tetraplegia and paraplegia, as well as, compare these results with data from traditional arm exercises (ie, biceps curl and shoulder press) with light weights which are commonly prescribed for a home program.

Participants

Fourteen individuals with chronic SCI (9 tetraplegia, 5 paraplegia).

Design

We measured upper limb muscle activation with surface electromyography (EMG) during Wii Sports video game play. Muscle activation was recorded from the playing arm during 4 selected games and normalized to a maximum voluntary contraction (MVC).

Outcome measures

Heart rate and upper limb motion were recorded simultaneously with EMG. Wilcoxon signed rank tests were used to analyze differences in muscle activation between participants with paraplegia versus tetraplegia and compare gaming with traditional arm exercises with light weights. A Friedman 2-way analysis of variance identified key muscle groups active during game play.

Results

Overall muscle activation across the games was not different between those with paraplegia and tetraplegia. Heart rate during video game play for tennis and boxing were on average 10 to 20 beats/minute above resting heart rate. The magnitude of EMG was relatively greater for traditional arm exercises with light weights compared with game play.

Conclusion

The selected Wii games were able to elicit upper extremity muscle activation and elevated heart rates for individuals with SCI that may be used to target therapeutic outcomes.

Keywords:

• Paraplegia
• Tetraplegia
• Video games
• EMG
• Upper limb
• Exercise

Acknowledgement

We would like to thank Daniel Fong, DPT for the assistance in collecting these data.

Disclaimer statements

Contributors All authors have contributed significantly to the design, analysis and writing of this manuscript. The contents represent original work and have not been published elsewhere.

Funding This study was supported by the Department of Veteran Affairs, Veterans Health Administration, Rehabilitation Research and Development Service, Merit Award [B7406-P].

Conflicts of interest There are no conflicts of interest to disclose.

Ethics approval The Institutional Review Board for the study site reviewed and approved this project.