{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T10:56:54Z","timestamp":1768993014964,"version":"3.49.0"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,8,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Children with cerebral palsy (CP) are prone to secondary complications related to physical inactivity and poor cardiorespiratory capacity. This problem could be greatly attenuated through the use of video games that incorporate physical activity for 2 reasons: Video games already represent an important component of leisure time in younger people, and such games can lead to a high level of exercise intensity in people who are healthy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The study objective was to evaluate exercise intensity in children with spastic diplegic CP and children who were typically developing while playing with an active video game console.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This was a cross-sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ten children (7\u201312 years old) with spastic diplegic CP (Gross Motor Function Classification System level I or II) and 10 children who were age matched and typically developing were evaluated in a movement analysis laboratory. Four games were played with the active video game console (jogging, bicycling, snowboarding, and skiing) for 40 minutes. Heart rate was recorded during the entire playing period with a heart rate belt monitor. Exercise intensity was defined as the percentage of heart rate reserve (HRR). In addition, lower extremity motion analysis was carried out during the final minute of the playing period for the jogging and bicycling games.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No difference between groups was observed for any variables. A main effect of games was observed for the amount of time spent at an intensity greater than 40% of HRR. Specifically, more than 50% of the playing time for the jogging game and more than 30% of the playing time for the bicycling game were spent at an intensity greater than 40% of HRR. In addition, the jogging game produced a larger range of motion than the bicycling game.<\/jats:p><\/jats:sec><jats:sec><jats:title>Limitations<\/jats:title><jats:p>A limitation of this study was the relatively small and heterogeneous sample.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For all 4 games, similar exercise intensity levels were observed for children who were typically developing and children with CP, suggesting that children with CP could obtain exercise-related benefits similar to those obtained by children without CP while playing with an active video game console.<\/jats:p><\/jats:sec>","DOI":"10.2522\/ptj.20120204","type":"journal-article","created":{"date-parts":[[2013,4,12]],"date-time":"2013-04-12T03:15:03Z","timestamp":1365736503000},"page":"1084-1091","source":"Crossref","is-referenced-by-count":41,"title":["Exercise Intensity Levels in Children With Cerebral Palsy While Playing With an Active Video Game Console"],"prefix":"10.1093","volume":"93","author":[{"given":"Maxime","family":"Robert","sequence":"first","affiliation":[{"name":"M. Robert, MSc, Centre de R\u00e9adaptation Marie Enfant, CHU Sainte-Justine, Montr\u00e9al, Qu\u00e9bec, Canada; Universit\u00e9 du Qu\u00e9bec \u00e0 Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada; and Groupe de Recherche en Activit\u00e9 Physique Adapt\u00e9e (GRAPA), Montr\u00e9al, Qu\u00e9bec, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurent","family":"Ballaz","sequence":"additional","affiliation":[{"name":"L. Ballaz, PhD, Centre de R\u00e9adaptation Marie Enfant, CHU Sainte-Justine; Universit\u00e9 du Qu\u00e9bec \u00e0 Montr\u00e9al; and Groupe de Recherche en Activit\u00e9 Physique Adapt\u00e9e (GRAPA)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphael","family":"Hart","sequence":"additional","affiliation":[{"name":"R. Hart, MSc, Centre de R\u00e9adaptation Marie Enfant, CHU Sainte-Justine; Universit\u00e9 du Qu\u00e9bec \u00e0 Montr\u00e9al; and Groupe de Recherche en Activit\u00e9 Physique Adapt\u00e9e (GRAPA)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Lemay","sequence":"additional","affiliation":[{"name":"M. Lemay, PhD, Centre de R\u00e9adaptation Marie Enfant, CHU Sainte-Justine; Universit\u00e9 du Qu\u00e9bec \u00e0 Montr\u00e9al; and Groupe de Recherche en Activit\u00e9 Physique Adapt\u00e9e (GRAPA). Mailing address: Centre de R\u00e9adaptation Marie Enfant, 5200 B\u00e9langer Est, Montr\u00e9al, Qu\u00e9bec, Canada H1T 1C9."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","reference":[{"key":"2019123011580336100_B1","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1111\/j.1469-8749.1990.tb16945.x","article-title":"Energy expenditure index of walking for normal children and for children with cerebral palsy","volume":"32","author":"Rose","year":"1990","journal-title":"Dev Med Child Neurol"},{"key":"2019123011580336100_B2","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1016\/S0022-3476(95)70115-X","article-title":"Daily physical activity of schoolchildren with spastic diplegia and of healthy control subjects","volume":"127","author":"van den Berg-Emons","year":"1995","journal-title":"J Pediatr"},{"key":"2019123011580336100_B3","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.2522\/ptj.20060116","article-title":"Promotion of physical fitness and prevention of secondary conditions for children with cerebral palsy: Section on Pediatrics research summit proceedings","volume":"87","author":"Fowler","year":"2007","journal-title":"Phys Ther"},{"key":"2019123011580336100_B4","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.adolescence.2005.08.016","article-title":"A descriptive epidemiology of screen-based media use in youth: a review and critique","volume":"29","author":"Marshall","year":"2006","journal-title":"J Adolesc"},{"key":"2019123011580336100_B5","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1109\/MCG.2008.92","article-title":"Bringing VR and spatial 3D interaction to the masses through video games","volume":"28","author":"LaViola","year":"2008","journal-title":"IEEE Comput Graph Appl"},{"key":"2019123011580336100_B6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3109\/01942630903476131","article-title":"Virtual reality: we are virtually there","volume":"30","author":"Snider","year":"2010","journal-title":"Phys Occup Ther Pediatr"},{"key":"2019123011580336100_B7","first-page":"975","article-title":"American College of Sports Medicine position stand: the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults","volume":"30","author":"American College of Sports Medicine","year":"1998","journal-title":"Med Sci Sports Exerc"},{"key":"2019123011580336100_B8","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1097\/PEP.0b013e31804a57a8","article-title":"Heart rate response to therapeutic riding in children with cerebral palsy: an exploratory study","volume":"19","author":"Dirienzo","year":"2007","journal-title":"Pediatr Phys Ther"},{"key":"2019123011580336100_B9","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1123\/jpah.7.3.393","article-title":"The physiological cost and enjoyment of Wii Fit in adolescents, young adults, and older adults","volume":"7","author":"Graves","year":"2010","journal-title":"J Phys Act Health"},{"key":"2019123011580336100_B10","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1542\/peds.2008-2851","article-title":"Playing active video games increases energy expenditure in children","volume":"124","author":"Graf","year":"2009","journal-title":"Pediatrics"},{"key":"2019123011580336100_B11","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.2522\/ptj.20080062","article-title":"Use of a low-cost, commercially available gaming console (Wii) for rehabilitation of an adolescent with cerebral palsy","volume":"88","author":"Deutsch","year":"2008","journal-title":"Phys Ther"},{"key":"2019123011580336100_B12","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1007\/s12160-010-9164-x","article-title":"Motivation and physiologic responses of playing a physically interactive video game relative to a sedentary alternative in children","volume":"39","author":"Penko","year":"2010","journal-title":"Ann Behav Med"},{"key":"2019123011580336100_B13","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1016\/j.apmr.2010.07.216","article-title":"Energy expenditure in adults with cerebral palsy playing Wii Sports","volume":"91","author":"Hurkmans","year":"2010","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123011580336100_B14","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1136\/bmj.39415.632951.80","article-title":"Comparison of energy expenditure in adolescents when playing new generation and sedentary computer games: cross sectional study","volume":"335","author":"Graves","year":"2007","journal-title":"BMJ"},{"key":"2019123011580336100_B15","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.jsams.2010.07.005","article-title":"Energy expended by boys playing active video games","volume":"14","author":"White","year":"2011","journal-title":"J Sci Med Sport"},{"key":"2019123011580336100_B16","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1249\/MSS.0b013e3181c51c78","article-title":"METs in adults while playing active video games: a metabolic chamber study","volume":"42","author":"Miyachi","year":"2010","journal-title":"Med Sci Sports Exerc"},{"key":"2019123011580336100_B17","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1001\/archpediatrics.2010.104","article-title":"Active video games to promote physical activity in children and youth: a systematic review","volume":"164","author":"Biddiss","year":"2010","journal-title":"Arch Pediatr Adolesc Med"},{"key":"2019123011580336100_B18","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1111\/j.1469-8749.2009.03434.x","article-title":"Muscle deficits in cerebral palsy and early loss of mobility: can we learn something from our elders?","volume":"51","author":"Shortland","year":"2009","journal-title":"Dev Med Child Neurol"},{"key":"2019123011580336100_B19","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1016\/j.apmr.2012.02.033","article-title":"Active video game play in children with cerebral palsy: potential for physical activity promotion and rehabilitation therapies","volume":"93","author":"Howcroft","year":"2012","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123011580336100_B20","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1519\/JSC.0b013e318207eae9","article-title":"Metabolic responses to Wii Fit video games at different game levels","volume":"25","author":"Worley","year":"2011","journal-title":"J Strength Cond Res"},{"key":"2019123011580336100_B21","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/j.jpeds.2009.01.009","article-title":"Activity-promoting video games and increased energy expenditure","volume":"154","author":"Lanningham-Foster","year":"2009","journal-title":"J Pediatr"},{"key":"2019123011580336100_B22","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1016\/j.clinbiomech.2010.06.011","article-title":"Ankle range of motion is key to gait efficiency in adolescents with cerebral palsy","volume":"25","author":"Ballaz","year":"2010","journal-title":"Clin Biomech (Bristol, Avon)"},{"key":"2019123011580336100_B23","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1097\/PEP.0b013e3181beb039","article-title":"Effects of aquatic aerobic exercise for a child with cerebral palsy: single-subject design","volume":"21","author":"Retarekar","year":"2009","journal-title":"Pediatr Phys Ther"},{"key":"2019123011580336100_B24","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1080\/02701367.2010.10599707","article-title":"Evaluating the prediction of maximal heart rate in children and adolescents","volume":"81","author":"Mahon","year":"2010","journal-title":"Res Q Exerc Sport"},{"key":"2019123011580336100_B25","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1590\/S0066-782X2011005000078","article-title":"Validity of maximum heart rate prediction equations for children and adolescents","volume":"97","author":"Machado","year":"2011","journal-title":"Arq Bras Cardiol"},{"key":"2019123011580336100_B26","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1111\/j.1469-8749.2011.03989.x","article-title":"The 220\u2212age equation does not predict maximum heart rate in children and adolescents","volume":"53","author":"Verschuren","year":"2011","journal-title":"Dev Med Child Neurol"},{"key":"2019123011580336100_B27","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1097\/00005768-199604000-00015","article-title":"Heart rate monitoring to assess energy expenditure in children with reduced physical activity","volume":"28","author":"van den Berg-Emons","year":"1996","journal-title":"Med Sci Sports Exerc"},{"key":"2019123011580336100_B28","doi-asserted-by":"crossref","first-page":"517","DOI":"10.2165\/00007256-200333070-00004","article-title":"Heart rate monitoring: applications and limitations","volume":"33","author":"Achten","year":"2003","journal-title":"Sports Med"},{"key":"2019123011580336100_B29","doi-asserted-by":"crossref","first-page":"92","DOI":"10.2340\/16501977-1072","article-title":"Does clinical rehabilitation impose sufficient cardiorespiratory strain to improve aerobic fitness?","volume":"45","author":"Koopman","year":"2013","journal-title":"J Rehabil Med"},{"key":"2019123011580336100_B30","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1016\/j.jpeds.2005.01.055","article-title":"Evidence based physical activity for school-age youth","volume":"146","author":"Strong","year":"2005","journal-title":"J Pediatr"},{"key":"2019123011580336100_B31","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1093\/ptj\/67.2.206","article-title":"Interrater reliability of a modified Ashworth scale of muscle spasticity","volume":"67","author":"Bohannon","year":"1987","journal-title":"Phys Ther"},{"key":"2019123011580336100_B32","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/1471-2474-9-44","article-title":"Reliability of Ashworth and Modified Ashworth scales in children with spastic cerebral palsy","volume":"9","author":"Mutlu","year":"2008","journal-title":"BMC Musculoskelet Disord"},{"key":"2019123011580336100_B33","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1097\/PHM.0b013e31823caae1","article-title":"Botulinum toxin a treatment in children with cerebral palsy: its effects on walking and energy expenditure","volume":"91","author":"Balaban","year":"2012","journal-title":"Am J Phys Med Rehabil"},{"key":"2019123011580336100_B34","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/S0966-6362(99)00009-0","article-title":"The energy expenditure of normal and pathologic gait","volume":"9","author":"Waters","year":"1999","journal-title":"Gait Posture"},{"key":"2019123011580336100_B35","doi-asserted-by":"crossref","first-page":"1867","DOI":"10.1093\/ptj\/67.12.1867","article-title":"Clinical measurement of range of motion: review of goniometry emphasizing reliability and validity","volume":"67","author":"Gajdosik","year":"1987","journal-title":"Phys Ther"},{"key":"2019123011580336100_B36","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1097\/01.pep.0000233054.26082.4e","article-title":"Relationships among measures of knee musculoskeletal impairments, gross motor function, and walking efficiency in children with cerebral palsy","volume":"18","author":"Goh","year":"2006","journal-title":"Pediatr Phys Ther"},{"key":"2019123011580336100_B37","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/S0003-9993(03)00379-4","article-title":"Test-retest reliability of hand-held dynamometric strength testing in young people with cerebral palsy","volume":"85","author":"Taylor","year":"2004","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123011580336100_B38","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/S0003-9993(98)90287-8","article-title":"Functional outcomes of strength training in spastic cerebral palsy","volume":"79","author":"Damiano","year":"1998","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123011580336100_B39","first-page":"001","article-title":"Variations in movement patterns during active video game play in children with cerebral palsy","author":"Berry","year":"2011","journal-title":"J Bioeng Biomed Sci"},{"key":"2019123011580336100_B40","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.2466\/pms.2002.95.3f.1047","article-title":"An assessment of the validity and reliability of two perceived exertion rating scales among Hong Kong children","volume":"95","author":"Leung","year":"2002","journal-title":"Percept Mot Skills"},{"key":"2019123011580336100_B41","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1053\/mr.2000.4429","article-title":"Gait in adolescent cerebral palsy: the effect of partial unweighting","volume":"81","author":"McNevin","year":"2000","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123011580336100_B42","doi-asserted-by":"crossref","first-page":"1674","DOI":"10.1249\/01.MSS.0000142312.43629.D8","article-title":"Responses of children with cerebral palsy to treadmill walking exercise in the heat","volume":"36","author":"Maltais","year":"2004","journal-title":"Med Sci Sports Exerc"},{"key":"2019123011580336100_B43","volume-title":"Foundations of Clinical Research: Applications to Practice","author":"Portney","year":"2000","edition":"2nd ed"},{"key":"2019123011580336100_B44","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1123\/pes.22.1.7","article-title":"Use of active video games to increase physical activity in children: a (virtual) reality?","volume":"22","author":"Foley","year":"2010","journal-title":"Pediatr Exerc Sci"},{"key":"2019123011580336100_B45","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1097\/PEP.0b013e31818b7ccd","article-title":"Systematic review of progressive strength training in children and adolescents with cerebral palsy who are ambulatory","volume":"20","author":"Mockford","year":"2008","journal-title":"Pediatr Phys Ther"},{"key":"2019123011580336100_B46","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.gaitpost.2005.10.008","article-title":"Do dynamic and static clinical measurements correlate with gait analysis parameters in children with cerebral palsy?","volume":"24","author":"Desloovere","year":"2006","journal-title":"Gait Posture"},{"key":"2019123011580336100_B47","doi-asserted-by":"crossref","first-page":"e636","DOI":"10.1542\/peds.2011-2050","article-title":"Impact of an active video game on healthy children's physical activity","volume":"129","author":"Baranowski","year":"2012","journal-title":"Pediatrics"},{"key":"2019123011580336100_B48","doi-asserted-by":"crossref","first-page":"120","DOI":"10.3109\/17518420903357753","article-title":"Virtual reality as a therapeutic modality for children with cerebral palsy","volume":"13","author":"Snider","year":"2010","journal-title":"Dev Neurorehabil"},{"key":"2019123011580336100_B49","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/j.physbeh.2008.01.010","article-title":"Association of liking and reinforcing value with children's physical activity","volume":"93","author":"Roemmich","year":"2008","journal-title":"Physiol Behav"},{"key":"2019123011580336100_B50","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1006\/pmed.1998.0307","article-title":"Determinants of exercise among children, II: a longitudinal analysis","volume":"27","author":"DiLorenzo","year":"1998","journal-title":"Prev Med"},{"key":"2019123011580336100_B51","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1097\/01241398-199611000-00010","article-title":"Strategies for increasing walking speed in diplegic cerebral palsy","volume":"16","author":"Abel","year":"1996","journal-title":"J Pediatr Orthop"}],"container-title":["Physical Therapy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ptj\/article-pdf\/93\/8\/1084\/31641698\/ptj1084.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ptj\/article-pdf\/93\/8\/1084\/31641698\/ptj1084.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,13]],"date-time":"2022-02-13T16:23:06Z","timestamp":1644769386000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ptj\/article\/93\/8\/1084\/2735526"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,8,1]]},"references-count":51,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2013,8,1]]}},"URL":"https:\/\/doi.org\/10.2522\/ptj.20120204","relation":{},"ISSN":["0031-9023","1538-6724"],"issn-type":[{"value":"0031-9023","type":"print"},{"value":"1538-6724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,8,1]]}}}