Effects of a video game based aerobic training program on aerobic power and executive functions in cerebral palsy: a pilot study

Abstract

Purpose: In this study we aimed to determine how aerobic training program will affect executive functions and cognition in individuals with spastic cerebral palsy (CP).

Method: We applied a game based aerobic training program for 12 weeks to 10 individuals (3 girls, 7 boys) with spastic CP whose ages ranged from 10 to 18 years. Training program consisted of some aerobic exercises like running, step up and down stairs, jumping, and an interactive video game. Before and after the training program, we measured their aerobic power using a cycle ergometer. We also evaluated their attention and executive functions with the Cancellation Test and Simon Test.

Results: After a 12 weeks aerobic training program, aerobic power levels of the participants increased significantly. (Aerobic power; pre-training: 30.2±9.7 mL.kg-1.min-1 post-training: 32.3±9.8 mL.kg-1.min-1) (p˂0.05). There were significant improvements in the Cancellation Test. The number of overall correct marks increased while the number of skipped targets decreased (correct marks; pre-training: 225.3±9.5-post-training: 233.5±5.4) (skipped targets; pre-training: 14±9.5- post-training: 6.7±5.6) (p<0.05). There are improvements in the Simon Test too. While number of the total responses increased, total reaction time and reaction time of the correct responses decreased, but these changes were not statistically significant (p>0.05).

Conclusion: Our study showed that, video game based aerobic training program positively affected aerobic power levels of individuals with spastic CP. At the same time, cognitive functions such as attention and executive scores also demonstrated a significant increase. This has led to the idea that thew aerobic training program can improve some cognitive functions.

Keywords

• Cerebral palsy,Aerobic exercise,Executive functions

Serebral palside video oyun tabanlı aerobik eğitim programının aerobik güç ve yürütücü işlevler üzerindeki etkileri: pilot çalışma

Abstract

Amaç: Bu çalışmanın amacı, aerobik eğitim programının, spastik serebral palsili (SP) bireylerde aerobik güç ve yürütücü işlevler üzerinde etkilerini araştırmaktı.

Yöntem: Çalışmaya yaşları 10-18 arasında değişen 10 spastik SP’li birey (3 kız 7 erkek) dahil edildi ve 12 hafta boyunca video oyunu temelli aerobik eğitim programına dahil edildiler. Eğitim programı, koşma, merdiven inip çıkma, zıplama gibi aktivitelerden ve interaktif bir video oyunundan oluşmaktaydı. Aerobik gücü değerlendirmek için Astrand Bisiklet Ergometresi Testi; dikkat ve yönetici işlevleri değerlendirmek için Simon Testi ve İşaretleme Testi eğitim programı öncesinde ve sonrasında uygulandı.

Bulgular: Eğitim programı sonucunda SP’li bireylerin aerobik güç düzeylerinde artış saptandı (Aerobik güç: eğitim öncesi: 30,2±9,7 mL.kg-1.dk-1, eğitim sonrası: 32,3±9,8 mL.kg-1.dk-1) (p<0,05). Benzer sonuçlar İşaretleme Testinde de sağlandı (p<0,05). İşaretlenen doğru sayısında artma; atlanan hedef sayısında da azalma gözlendi. Eğitim öncesi testte doğru sayısı 225,3±9,5, eğitim sonrası testte ise 233,5±5,4 oldu (p<0,05). Atlanan hedef sayısı eğitim öncesi testte 14,7±9,5; eğitim sonrası testte ise 6,7±5,6 oldu (p<0,05). Simon Testi’nde toplam doğru sayısında artış, toplam tepki süresi ve doğruların tepki süresinde azalma gözlense bile fark anlamlı değildi (p>0,05).

Sonuç: Bu sonuçlar, video oyunu temelli aerobik eğitim programı spastik SP’li bireylerin aerobik güç düzeylerini olumlu yönde etkilediği görüldü. Aynı zamanda dikkat ve yürütücü işlevler gibi birtakım bilişsel işlevlerin skorlarında da anlamlı artış gözlendi. Bu da aerobik eğitim programının, birtakım bilişsel işlevleri geliştirebileceğini düşündürmüştür.

Keywords

• Serebral palsi,Aerobik egzersiz,Yürütücü işlevler

References

1. 1. Bax M, Goldstein M, Rosenbaum P, et al. Proposed definition and classification of cerebral palsy. Dev Med Child Neurol 2005;47:571-576.
2. 2. Luciana M. Cognitive development in children born preterm: Implications for theories of brain plasticity following early injury. Dev Psychopathol. 2003;15:1017-1047.
3. 3. Catroppa C, Anderson V. Recovery in memory function, and its relationship to academic success, at 24 months following pediatric TBI. Child Neuropsychol. 2007;13:240-261.
4. 4. Scott MA, Fletcher JM, Brookshire BL, et al. Memory functions in children with early hydrocephalus. Neuropsychology. 1998;12:578589.
5. 5. Mirsky AF. The neuropsychology of attention: Elements of a complex behavior. In E. Perecman (Ed.), Integrating theory and practice in clinical neuropsychology 1989 (pp.75-91). Hillsdale, NJ: Lawrence Erlbaum Associates.
6. 6. Bates E, Thal D, Trauner D, et al. From first words to grammar in children with focal brain injury. Dev Neuropsychol. 1997;13:275-343.
7. 7. Gathercole SE. The development of memory. J Child Psychol Psychiatry. 1998;39:3-27.
8. 8. Nieuwenhuijsen C, van der Slot WM, Beelen A, et al. Inactive lifestyle in adults with bilateral spastic cerebral palsy. J Rehabil Med. 2009;41:375-81.

9. 9. Bandini LG, Schoeller DA, Fukogawa NK, et al. Body composition and energy expenditure in adolescents with cerebral palsy or myelodysplasia. Pediatr Res. 1991;29:70-77.
10. 10. M Ploughman. Exercise is brain food: the effects of physical activity on cognitive function. Dev Neurorehabil. 2008;11:236-240.
11. 11. Kramer AF, Hahn S, Cohen NJ et al. Ageing, fitness and neurocognitive function. Nature. 1999;400:418-419.
12. 12. Kleim JA, Cooper NR, VandenBerg PM. Exercise induces angiogenesis but does not alter movement representations within rat motor cortex. Brain Res. 2002;934:1-6.
13. 13. McMorrris T, Collard K, Corbet J et al. A test of catecholamines hypothesis for an acute exercise-cognition interaction. Pharmacol Biochem Behav. 2008;89:106-115.
14. 14. Schinder AF, Poo M. The neurotrophin hypothesis for synaptic plasticity. Trends Neurosci. 2000;23:639-645.
15. 15. Buono MJ, Roby JJ, Micale FG, et al. Predicting maximal oxygen uptake in children: modification of the Astrand-Ryhming test. Pediatr Exerc Sci. 1989;1:278-283.
16. 16. Lundberg A, Ovenfors CO, Saltin B. Effect of physical training on school children with cerebral palsy. Acta Pediatr Scand. 1967;56:181-188.
17. 17. Verschuren O, Ketelaar M, Gorter JW, et al. Exercise training program in children and adolescents with cerebral palsy. A randomized controlled trial. Arch Pediatr Adolesc Med. 2007;161:1075-1081.
18. 18. Van den Berg-Emons RJ, Van Baak MA, Speth L, et al. Physical training of school children with spastic cerebral palsy: effects on daily activity, fat mass and fitness. Int J Rehabil Res. 1998;21:179-194.
19. 19. Shinohara TA, Suzuki N, Oba M, et al. Effects of exercise at the AT point for children with cerebral palsy. Bull Hosp Jt Dis. 2002;61:63-67.
20. 20. Unnithan VB, Katsumanis G, Evangelinou C, et al. Effect of aerobic strength training in children with cerebral palsy. Med Sci Sports Exerc. 2007;39:1902-1909.
21. 21. Verschuren O, Peterson MD, Balemans AC, et al. Exercise and physical activity recommendations for people with cerebral palsy. Dev Med Child Neurol. 2016;58:798-808.