STUDY DESIGN: Randomized controlled trial. OBJECTIVES: To compare the effects of wobble board exercises with and without feedback provided through integrating the wobble board movement into a computer game system, by comparing changes in postural stability and motivation. BACKGROUND: Therapeutic exergaming systems may offer a solution to poor adherence to postural control exercise regimes by improving motivation levels during exercise performance. METHODS: Twenty-two healthy adults, randomly assigned to an exergaming group (n = 11) and a control group (n = 11), completed 12 exercise sessions. Dynamic postural stability was quantified at baseline and follow-up using the star excursion balance test and the dynamic postural stability index during a jump-landing task. Intrinsic motivation was measured at baseline using the Self-Motivation Inventory and at follow-up using the Intrinsic Motivation Inventory. RESULTS: Star excursion balance test scores showed a statistically significant (P<.008) improvement in the posteromedial and posterolateral direction for both groups. No within-group change for the dynamic postural stability index or between-group difference for star excursion balance test or dynamic postural stability index scores were observed. The ìinterest and enjoymentî category of the Intrinsic Motivation Inventory showed significantly higher scores (P<.001) in the exergaming group at follow-up, which was 1 of the 5 Intrinsic Motivation Inventory categories evaluated. CONCLUSIONS: The findings suggest that exercising with the therapeutic exergaming system showed similar improvements in dynamic postural stability and showed a greater level of interest and enjoyment when compared to a group doing similar balance training without the game system. LEVEL OF EVIDENCE: Therapy, level 2b.

J Orthop Sports Phys Ther 2010;40(1):11-19, Epub 7 December 2009. doi:10.2519/jospt.2010.3121

KEY WORDS: computer games, exercise adherence, intrinsic motivation, postural stability training, rehabilitation

The Third International Ankle Symposium (IAS3), a multidisciplinary conference focused on topics related to ankle sprains, instability, and rehabilitation, was recently held in Dublin, Ireland on the campus of University College Dublin. The organizing committee included: Brian Caulfield (University College Dublin), Garrett Coughlan (University College Dublin), Eamonn Delahunt (University College Dublin), Ruth Gibson (St. Vincent’s University Hospital, Dublin), Jay Hertel (University of Virginia), Thomas Kaminski (University of Delaware), Phillip Gribble (University of Toledo) and Kenneth Monaghan (University College Dublin). This symposium served to follow up on the solid foundations laid down at previous symposia in Ulm, Germany in 2000 and Delaware, USA in 2004.

IAS3 brought together over 150 clinicians and scientists from disciplines such as physiotherapy, athletic training, orthopaedics, podiatry, and biomechanics. Participants represented many countries, including Australia, New Zealand, Brazil, Belgium, Germany, Ireland, Great Britain, Denmark, Switzerland, Portugal, Norway, Canada, and the United States. A call for abstracts was initially distributed in late 2005. Prospective attendees were invited to submit abstracts of work relating to original research, case studies, or clinical commentaries. All submitted abstracts were reviewed for scientific merit by members of the organizing committee. Fifty-four abstracts were accepted and presented at the symposium.

The scientific program consisted of 8 invited keynote lectures from internationally recognized experts and 22 podium and 32 poster presentations of original research. The choice of keynote lecture topics and speakers was designed to appeal to clinicians and scientists alike and the keynote series included lectures on features and causes of ankle instability as well as clinical lectures relating to assessment and rehabilitation of ankle injuries. The symposium was kicked off with a presentation from an Irish rugby star, Mr. Gordon D’Arcy, who spoke about injury management and scientific research from the perspective of the professional sportsperson. The symposium also provided for considerable scholarly and social interaction among the attendees. A highlight of the weekend was a state reception that was hosted by An Tánaiste, Mary Harney TD (the Irish Deputy Prime Minister) in the historic Iveagh House to honor the occasion of the symposium being held in Ireland.

The meeting also provided an opportunity for further development of the work of the International Ankle Consortium, a multidisciplinary group that was formed at IAS2 with the aim of promoting increased harmonization and collaboration in ankle research. Members of this group presented a discussion poster at the conference with the aim of stimulating debate on standards for classification of subjects in ankle instability research. Plans have already commenced for the Fourth International Ankle Symposium, which will be held in Australia during July 2008. Included in this article are a summary statement for the conference, abstracts of the keynote lectures, and the abstracts of the original research presentations (podium and poster) from IAS3.

J Orthop Sports Phys Ther. 2006; 36(11):A1-A27. doi:10.2519/jospt.2006.0302