Health and leisure time physical activity promotion through exergaming for individulas with spinal cord injury / Maziah Mat Rosly

Individuals with spinal cord injury (SCI) face challenges in maintaining leisure time physical activity (LTPA) participation and adherence to exercise. LTPA is important for improving fitness, quality of life and cardiometabolic profiles. However, epidemiological data among community-dwelling SCI revealed low participation (29-53%) in “dosepotent” LTPA, defined as aerobic exercise of moderate-vigorous intensity for health benefits. The studies provided evidence that participation in LTPA is related to barriers due to wheelchair dependency. Recurrent themes often cited include expensive equipment, boring and monotonous exercises, issues with transportation and the inaccessibility of training facilities. The Physical Activity Scale for Individuals with Physical Disabilities and the Barriers to Exercise Scale questionnaires were used to collect descriptive information on LTPA and the associated barriers to exercise. Adaptation and translation of these questionnaires to fit Malaysian cultural competency were proceeded with validation of its Malaysian rendition (Chapter 3). Dose-potent LTPA participation (Chapter 4), assessed within the scenario of a non-western culture and Asian developing country revealed low participation (27%). The majority of respondents came from a lower socioeconomic bracket, 70% with a monthly household income of less than RM2500; including 27% of them earning less than RM1000. The top three barriers reported were costly exercise equipment (54%), pain while exercising (37%) and no access to facilities (36%). Significant predictors for dose-potent exercise participation were age more than 35 years old, ethnicity, reporting transportation difficulties and health concerns. A systematic review (Chapter 4) explored the exercise alternative, “exergaming” (a combination of active bodily movements with video gaming) for iv population with neurological disabilities. The review concluded that exergaming could provide moderate or vigorous intensity aerobic exercise as recommended by health guidelines. An exergaming pilot study (Chapter 4) in adult SCI demonstrated its feasibility to produce adequate “dose-potency” prescribed for health benefits. There were significant physiological differences (p<0.05) in the metabolic responses while exergaming using Move Tennis (unilateral, dominant upper limb movements) against Move Boxing and Move Gladiator Duel (bilateral upper limb movements). Move Kayaking was adapted for use among a study sample with SCI. In Chapter 4, physiological responses between Move Boxing and heavy-bag boxing revealed no significant differences (p>0.05), with only small to moderate effect sizes (Cohen’s d, 0.02-0.49). However, Move Boxing was perceived to be more enjoyable, easier to assemble, comfortable to use, motivating for longer duration and for home training. The final study (Chapter 5) assessed three different exercise types (Move Boxing, Move Kayaking and arm cranking) that were conducted within similar training zones to compare the ratings of perceived exertion (RPE) and enjoyment. All three exercise types achieved vigorous intensity according to the peak heart rate. Move Boxing was the most significantly (p<0.05) enjoyable exercise compared to Move Kayaking and arm cranking. Exergaming’s RPE was significantly (p<0.05) more than arm cranking owing to the complex arm movements during gameplay. Move Boxing reported higher RPE but was significantly more enjoyable than arm cranking

Health and leisure time physical activity promotion through exergaming for individuals with spinal cord injury

This thesis comprised of six critical studies divided into three phases, which evaluated the context, explored available alternatives to exercise and sought to improve the unsettling scenario of “sedentary” lifestyles among individuals with spinal cord injury (SCI). In the first phase, descriptive information on moderate to vigorous exercises and its associated barriers to participation were extracted among community-dwelling SCI. The approach used non-invasive instruments (validated questionnaires) which allowed description of activities and the associated barriers in large epidemiological studies. The second phase, sought to explore and provide a scientifically grounded alternative to exercise termed “exergaming” (a combination of exercise and gaming with body movements) for this population in the form of a systematic review and a pilot study. The third and final phase of the thesis involved comparing exergaming to conventional exercise counterparts whilst finding directions for improvement

Leisure time physical activity participation in individuals with spinal cord injury in Malaysia: barriers to exercise

Study design: Cross-sectional. Objectives: An epidemiological study describing leisure time physical activities (LTPA) and the associations of barriers, sociodemographic and injury characteristics to moderate-vigorous aerobic exercise participation among individuals with spinal cord injury (SCI) in a developing Southeast Asian country. Setting: SCI community in Malaysia. Methods: The study sample consisted of 70 participants with SCI. Questionnaires were distributed containing an abbreviated Physical Activity Scale for Individuals with Physical Disabilities (items 2–6) and the Barriers to Exercise Scale using a 5-tier Likert format. Statistical analyses were χ 2 tests, odds ratios, and binary forward stepwise logistic regression to assess the association and to predict factors related to participation in moderate-vigorous intensity aerobic exercise (items 4 and 5). Results: Seventy-three percent of the study sample did not participate in any form of moderate or vigorous LTPA. The top three barriers to undertaking LTPA (strongly agree and agree descriptors) were expensive exercise equipment (54%), pain (37%) and inaccessible facilities (36%). Participants over the age of 35 years, ethnicity, health concerns, perceiving exercise as difficult and indicating lack of transport were significantly different (p < 0.05) between participation and non-participation in moderate-vigorous aerobic exercise type of LTPA. Age, ethnicity, indicated health concerns and lack of transport were the significant predictors in likelihood of participating in moderate-vigorous LTPA (p < 0.1). Conclusion: The issues raised depicted barriers within the intrapersonal (health concerns, exercising is too difficult, pain while exercising, age more than 35), interpersonal (different ethnicity), community (expensive exercise equipment), and policy levels (lack of or poor access to transportation, inaccessible facilities) that prevent LTPA participation

Clasp-Knife Model of Muscle Spasticity for Simulation of Robot-Human Interaction

The objective of this research was to replicate the muscle tone moment feedback of elbow upon passive mobilization and classify them based on modified ashworth scale criterion using a mathematical model. The proposed model enables the visualization of muscle tone pattern for robotic interaction simulation. A concurrent muscle tone model necessitates a jerk effect to fully replicate the catch and release effect, also known as, clasp-knife phenomenon of muscle tone feedback. However, the research of passive mobilization control interaction between robot and subject does not emulate such phenomenon. Thus, the model was improvised to replicate the clasp-knife phenomenon according to the robot's gross kinematics and dynamics. The model was designed based on the quantitative pattern of muscle tone feedback from subject with spasticity. The simulated model was then correlated to clinical measures using similar kinematic and dynamic input. The velocity dynamic input was splined to obtain the velocity trend without the jerk effect. The results obtained from the proposed model were relatively promising with an overall (n=9× 4) linear (Pearson) correlated average of -r=0.8348 for nine subjects with correlation significant at the 0.01 level (p< 0.01) and five of them presented a distinctive clasp-knife phenomenon with correlation average of -r=0.8631. © 2018 IEEE

Modified Ashworth Scale (MAS) integrated adaptive impedance control framework for upper extremity training platform

Robotic training platform are sought out for their promising therapeutic assistance. However, distinctive advancement has yet to resolve the monotonous and lopsided aspect of current system. Thus, this paper proposes the integration of Modified Ashworth Scale (MAS)-based assessment with dynamic impedance control model, presenting an artificial compliance within the robotic assisted training platform control framework. This enhancement is hypothesised to allow better accommodation of subject’s user input under specified training regimen. Feasibility study was verified via simulation of acceleration-based impedance model under MAS 0 and 1+ contraints for linear forward motion training regimen involving elbow extension

Children’s Physiological and Perceptual Responses to Sports Exergames When Played in Different Positions

Today’s children are prone to becoming involved in exergames, but their positions during play have not been sufficiently investigated to determine whether the positions they adopt result in equal responses. The design of this study involved the collection of physiological and perceptual responses (i.e., heart rate (HR), rating of perceived exertion, and enjoyment score) during exergames in three different sports (bowling, tennis, and boxing) with players in different positions (sitting and standing). The participants played each game for 10 min while their HR was recorded. After the gameplay, each perceptual response was retrieved. The results revealed a significant increase in HR above rest during exergaming overall (p p p p p > 0.5). For all the variables, no statistically significant differences between genders were identified (p > 0.5). This home-based intervention demonstrated that sports exergames are not only enjoyable; overall, they can provide at least moderately intense physical activity, whether played seated or standing

Improving Motor Skills in Early Childhood through Goal-Oriented Play Activity

Goal-oriented play activity encourages children to exercise and triggers the movement of body muscles. Active muscles are stronger, more agile, faster, and more powerful. Purpose: The purpose of this study is to determine that goal-oriented play activity in early childhood improves motor skills. Methods: Forty children aged 4.5–6 years old were recruited and took part in a set of training activities divided into Posts 1–5. To pass each post, a child had to run, walk on a balance beam, move sticks, throw and catch the ball, and arrange blocks. Training was given three times every week for 12 weeks. Data collected consisted of running 25 m, walking on the balance beam, throwing the ball as far as possible, locomotor movement, arranging cans, and bouncing the ball. Paired t and Wilcoxon signed-rank tests were used for analysis. Results: The results showed that there were significant differences in the motor skills evaluated pre- and post-training with p &lt; 0.05. Conclusion: All six training activities conducted for 12 weeks provided significant improvements in the motor skills areas in children aged 4.5–6 years old