***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIM To evaluate the effects of ' ' Playstation EyeToy Games ' ' on upper extremity motor recovery and upper extremity-related motor functioning of patients with subacute stroke . METHODS The authors design ed a r and omized , controlled , assessor-blinded , 4-week trial , with follow-up at 3 months . A total of 20 hemiparetic in patients ( mean age 61.1 years ) , all within 12 months post-stroke , received 30 minutes of treatment with ' ' Playstation EyeToy Games ' ' per day , consisting of flexion and extension of the paretic shoulder , elbow and wrist as well as abduction of the paretic shoulder or placebo therapy ( watching the games for the same duration without physical involvement into the games ) in addition to conventional program , 5 days a week , 2 - 5 hours/day for 4 weeks . Brunnstrom 's staging and self-care sub-items of the functional independence measure ( FIM ) were performed at 0 month ( baseline ) , 4 weeks ( post-treatment ) , and 3 months ( follow-up ) after the treatment . RESULTS The mean change score ( 95 % confidence interval ) of the FIM self-care score ( 5.5 [ 2.9 - 8.0 ] vs 1.8 [ 0.1 - 3.7 ] , P=0.018 ) showed significantly more improvement in the EyeToy group compared to the control group . No significant differences were found between the groups for the Brunnstrom stages for h and and upper extremity . CONCLUSION ' ' Playstation EyeToy Games ' ' combined with a conventional stroke rehabilitation program have a potential to enhance upper extremity-related motor functioning in subacute stroke patients In a  multiple-object tracking ( MOT ) task , young and older adults attentively tracked a subset of 10 identical , r and omly moving disks for several seconds , and then tried to identify those disks that had comprised the subset . Young adults who habitually played video games performed significantly better than those who did not . Compared to young subjects ( mean age = 20.6 years ) with whom they were matched for video game experience , older subjects ( mean age = 75.3 years ) showed much reduced ability to track multiple moving objects , particularly with faster movement or longer tracking times . Control measurements with stationary disks show that the age-related decline in MOT was not caused by a general change in memory per se . To generate an item-wise performance measure , we examined older subjects '  proportion correct according to the serial order in which individual disks were identified . Correct identification of target disks declined with the order in which targets were reported , suggesting that attentional tracking produced grade d , rather than all-or-none , outcomes Background Evidence suggests that increasing intensity of rehabilitation results in better motor recovery . Limited evidence is available on the effectiveness of an interactive virtual reality gaming system for stroke rehabilitation . EVREST was design ed to evaluate feasibility , safety and efficacy of using the Nintendo Wii gaming virtual reality ( VRWii ) technology to improve arm recovery in stroke patients . Methods Pilot r and omized study comparing , VRWii versus recreational therapy ( RT ) in patients receiving st and ard rehabilitation within six months of stroke with a motor deficit of ≥3 on the Chedoke-McMaster Scale ( arm ) . In this study we expect to r and omize 20 patients . All participants ( age 18–85 ) will receive customary rehabilitative treatment consistent of a st and ardized protocol ( eight sessions , 60 min each , over a two-week period ) . Outcome measures The primary feasibility outcome is the total time receiving the intervention . The primary safety outcome is the proportion of patients experiencing intervention-related adverse events during the study period . Efficacy , a secondary outcome measure , will be measured by the Wolf Motor Function Test , Box and Block Test , and Stroke Impact Scale at the four-week follow-up visit . From November , 2008 to September , 2009 21 patients were r and omized to VRWii or RT . Mean age , 61 ( range 41–83 ) years .  Mean time from stroke onset 25 ( range 10–56 ) days . Conclusions EVREST is the first r and omized parallel controlled trial assessing the feasibility , safety , and efficacy  of virtual reality using Wii gaming technology in stroke rehabilitation . The results of this study will serve as the basis for a larger multicentre trial . Clinical Trials.gov registration # Objective . To investigate the effectiveness of computerized virtual reality ( VR ) training of the hemiparetic h and of patients poststroke using a system that provides repetitive motor reeducation and skill reacquisition . Methods . Eight subjects in the chronic phase poststroke participated in a 3-week program using their hemiparetic h and in a series of interactive computer games for 13 days of training , weekend breaks , and pretests and posttests . Each subject trained for about 2 to 2.5 h per day . Outcome measures consisted of changes in the computerized measures of thumb and finger range of motion , thumb and finger velocity , fractionation ( the ability to move fingers independently ) , thumb and finger strength , the Jebsen Test of H and Function , and a Kinematic reach to grasp test . Results . Subjects as a group improved in fractionation of the fingers , thumb and finger range of motion , and thumb and finger speed , retaining those gains at the 1-week retention test . Transfer of these improvements was demonstrated through changes in the Jebsen Test of H and Function and a decrease after the therapy in the overall time from h and peak velocity to the moment when an object was lifted from the table . Conclusions . It is difficult in current service delivery models to provide the intensity of practice that appears to be needed to effect neural reorganization and functional changes poststroke . Computerized exercise systems may be a way to maximize both the patients ’ and the clinicians ’ time . The data in this study add support to the proposal to explore novel technologies for incorporation into current practice The combination of active video gaming and exercise ( exergaming ) is suggested to improve elderly people 's balance , thereby decreasing fall risk . Exergaming has been shown to increase motivation during exercise therapy , due to the enjoyable and challenging nature , which could support long-term adherence for exercising balance . However , scarce evidence is available of the direct effects of exergaming on postural control . Therefore , the aim of the study was to assess the effect of a six-week videogame-based exercise program aim ed at improving balance in elderly people .  Task performance and postural control were examined using an interrupted time series design . Results of multilevel analyses showed that performance on the dot task improved within the first two weeks of training . Postural control improved during the intervention . After the intervention period task performance and balance were better than before the intervention . Results of this study show that healthy elderly can benefit from a videogame-based exercise program to improve balance and that all subjects were highly motivated to exercise balance because they found gaming challenging and enjoyable The aims of this r and omized , single-blind crossover trial were to investigate the effect of adding a simulated bowling video game via the Nintendo Wii ® gaming system to the st and ard exercise regimen of cognitively intact residents of long-term care ( LTC ) with upper extremity dysfunction and to identify individual characteristics that might predict improvement . Residents ( n=34 ) were recruited through two LTC facilities in southwestern Ontario and were r and omized into a st and ard exercise ( SG ) or st and ard exercise plus Wii bowling ( Wii ) arm . After 4 weeks of intervention , the groups were crossed over to the opposite arm . Outcomes included measures of pain intensity and bothersomeness , physical activity enjoyment , and a six-item measure of functional capacity design ed specifically for residents of LTC . Results suggest that subjects improved on all outcomes from pre- to postintervention but that only enjoyment of activity showed a significant difference between the SG and Wii groups . Effect sizes ( Cohen 's d ) ranged from small ( 0.30 for bothersomeness ) to large ( 1.77 for functional capacity ) . Responders , defined as those subjects who reported any degree of improvement following the Wii intervention , were less likely to complain of stiffness or shoulder symptoms and were more likely to complain of h and symptoms than non-responders . Limitations in interpretation and recommendations for future research are presented Background Physical activity promotes health in older adults but participation rates are low . Interactive video dance games can increase activity in young persons but have not been design ed for use with older adults . The purpose of this research was to evaluate healthy older adults ’ interest and participation in a dance game adapted for an older user . Methods Healthy older adults were recruited from 3 senior living setting s and offered three months of training and supervision using a video dance game design ed for older people .  Before and after the program , data was collected on vital signs , physical function and self reported quality of life . Feedback was obtained during and after training . Results Of 36 persons who entered ( mean age 80.1 + 5.4 years , 83 % female ) , 25 completed the study . Completers were healthier than noncompleters . Completers showed gains in narrow walk time , self-reported balance confidence and mental health . While there were no serious adverse events , 4 of 11 noncompleters withdrew due to musculoskeletal complaints . Conclusions Adapted Interactive video dance is feasible for some healthy older adults and may help achieve physical activity goals The objective of this study was to investigate the potential of using a low-cost video-capture virtual reality ( VR ) platform , the Sony PlayStation II EyeToy , for the rehabilitation of older adults with disabilities . This article presents three studies that were carried out to provide information about the EyeToy 's potential for use in rehabilitation . The first study included the testing of healthy young adults ( N = 34 ) and compared their experiences using the EyeToy with those using GestureTek 's IREX VR system in terms of a sense of presence , level of enjoyment , control , success , and perceived exertion . The second study aim ed to characterize the  VR experience of healthy older adults ( N = 10 ) and to determine the suitability and usability of the EyeToy  for this population and the third study aim ed to determine the feasibility of the EyeToy for use by individuals ( N = 12 ) with stroke at different stages . The implication s of these three studies for applying the system to rehabilitation are discussed Background Due to the many problems associated with reduced balance and mobility , providing an effective and engaging rehabilitation regimen is essential to progress recovery from impairments and to help prevent further degradation of motor skills . Objectives The purpose of this study was to examine the feasibility and benefits of physical therapy based on a task-oriented approach delivered via an engaging , interactive video game paradigm . The intervention focused on performing targeted dynamic tasks , which included reactive balance controls and environmental interaction . Design This study was a r and omized controlled trial . Setting The study was conducted in a geriatric day hospital . Participants Thirty community-dwelling and ambulatory older adults attending the day hospital for treatment of balance and mobility limitations participated in the study . Interventions Participants were r and omly assigned to either a control group or an experimental group . The control group received the typical rehabilitation program consisting of strengthening and balance exercises provided at the day hospital . The experimental group received a program of dynamic balance exercises coupled with video game play , using a center-of-pressure position signal as the computer mouse . The tasks were performed while st and ing on a fixed floor surface , with progression to a compliant sponge pad . Each group received 16 sessions , scheduled 2 per week , with each session lasting 45 minutes . Measurements Data for the following measures were obtained before and after treatment : Berg Balance Scale , Timed “ Up & Go ” Test , Activities-specific Balance Confidence Scale , modified Clinical Test of Sensory Interaction and Balance , and spatiotemporal gait variables assessed in an instrumented carpet system test . Results Findings demonstrated significant improvements in posttreatment balance performance scores for both groups , and change scores were significantly greater in the experimental group compared with the control group . No significant treatment effect was observed in either group for the Timed “ Up & Go ” Test or spatiotemporal gait variables . Limitations The sample size was small , and there were group differences at baseline in some performance measures . Conclusion Dynamic balance exercises on fixed and compliant sponge surfaces were feasibly coupled to interactive game-based exercise . This coupling , in turn , result ed in a greater improvement in dynamic st and ing balance control compared with the typical exercise program . However , there was no transfer of effect to gait function OBJECTIVE To determine whether a dance mat test of choice stepping reaction time ( CSRT ) is reliable and can detect differences in fall risk in older adults . DESIGN R and omized order , crossover comparison . SETTING Balance laboratory , medical research institute , and retirement village . PARTICIPANTS Older ( mean age , 78.87±5.90y ; range , 65 - 90y ) independent-living people ( N=47 ) able to walk in place without assistance . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES Reaction ( RT ) , movement , and response times of dance pad -- based stepping tests , Physiological Profile Assessment ( PPA ) score , Digit Symbol Substitution Test ( DSST ) score , time to complete the Trail Making Test ( TMT ) A+B , Fall Efficacy Scale International ( FES-I ) score , Activities-specific Balance Confidence ( ABC ) Scale score , and Incidental and Planned Exercise Question naire ( IPEQ ) incidental IPEQ activity subscore . RESULTS Test-retest reliability of the dance mat CSRT  response time was high ( intraclass correlation coefficient model 3,k=.90 ; 95 % confidence interval [ CI ] , .82-.94 ; P<.001 ) and correlated highly with the existing laboratory-based measure ( r=.86 ; 95 % CI , .75-.92 ; P<.001 ) . Concurrent validity was shown by significant correlations between response time and measures of fall risk ( PPA : r=.42 ; 95 % CI , .15-.63 ; P<.01 ; TMT A : r=.61 ; 95 % CI , .39-.77 ; TMT B : r=.55 ; 95 % CI , .31-.72 ; DSST : r=-. 
    Output:
    
A majority of the studies revealed significant positive effects on health outcomes associated with digital videogame play among older adults .