THURSDAY, Feb. 25 (HealthDay News) -- Recovering stroke patients whose physical therapy regimen is built around Wii video games appear to improve better than patients treated with standard therapies, a new Canadian study reveals.

The finding suggests that the enormously popular virtual reality programs could move beyond fun and games into the serious business of physical rehabilitation.

"This is new technology that may potentially help patients with a stroke," said study lead author Dr. Gustavo Saposnik, director of the Stroke Outcomes Research Unit at St. Michael's Hospital at the University of Toronto, Canada. "We ran a pilot study to see whether this is doable, safe, and more effective than routine therapy," he said. "And we found it was."

The findings are scheduled for presentation Thursday at the international conference of the American Stroke Association in San Antonio, Texas.

The Wii gaming system -- produced by Nintendo, which did not fund the study -- allows players to physically interact in real-time with images displayed on TV screens through the use of wireless motion-detection remote controls.

To gauge the promise of a Wii-based rehabilitation program, Saposnik and his colleagues focused on 20 stroke survivors, average age 61, all of whom were recovering from mild to moderate ischemic (caused by vessel blockage) or hemorrhagic (bleeding) strokes.

The stroke survivors were randomly divided into two groups: one group assigned to standard recreational therapy for impaired arms, involving the playing of card games or the block-stacking game Jenga, and a second group assigned to Wii-based therapy, either playing virtual tennis or cooking virtually (through "Wii tennis" or "Wii Cooking Mama").

The Wii-based therapy involved movements that mimic the arm strokes required in a tennis match or those needed for cutting potatoes, peeling onions, slicing meat and shredding cheese.

Both the recreational and Wii-based therapies were administered in eight 60-minute sessions spread over two weeks. Both regimens were launched within two months following stroke occurrence, and both were described by the researchers as "intensive."

After two weeks, the Wii group showed greater improvements than the recreational group in the patients' affected arms, as measured in terms of the speed and grip strength necessary for normal motor function. No evidence of safety risk was found among the Wii group.

"Basically, we found that Wii therapy produced a 30 percent better improvement than recreational therapy in the time it took for the Wii patients to execute a task, and in how well they were able to execute a task," said Saposnik.

Saposnik said that if the apparent benefits of Wii therapy hold up to further scrutiny, the high-tech physical therapy approach could help address two paramount challenges patients face when embarking on a recovery program: time and access.

"Rehabilitation is time-consuming, which can translate into poor compliance," he noted. "And it's not always available to all patients, based on cost and insurance constraints. But the high-intensity, repetitive nature of Wii therapy seems to offer quick benefits, and it's widely available. So this could prove to be very helpful."

"However, this is just an initial step towards expanding our understanding of the potential benefit this kind of innovative, interactive approach in neuro-rehabilitation might have following a stroke," Saposnik cautioned.

"A larger study should be completed before making recommendations," he said. "And that is already under way."

Dr. William Meehan, director of the Sports Concussion Clinic at Children's Hospital Boston, said Saposnik's early observation makes "a lot of sense."

"In general terms, the use of computer programs with some sort of motor movement component has certainly already been shown to be of benefit in terms of helping patients regain balance control when dealing with a sports-related concussion," he said. "So I think this whole rehabilitation approach has great promise."

"And it is much more convenient than normal therapy, in that patients could perhaps do this kind of thing at home," Meehan added. "But, I would say it will probably end up best being used to augment standard therapies, because you do always want an actual therapist to monitor patient progress."

More information

For additional information on stroke recovery, visit the National Stroke Association.

THURSDAY, Feb. 25 (HealthDay News) -- Fatigue in dialysis patients may be a warning sign of an impending heart attack or other serious heart problems, a new study suggests.

Japanese researchers had 788 dialysis patients complete a fatigue questionnaire and found that about 16 percent of them had a high fatigue score. After two years of follow-up, patients with high fatigue scores were more than twice as likely to have suffered cardiovascular events, such as a heart attack or stroke.

The fatigue questionnaire used in the study differentiates fatigue from many factors associated with it, including anxiety, depression, pain, infection and overwork. The researchers found that fatigue was the strongest predictor of cardiovascular risk, even in patients with known risk factors, such as diabetes, malnutrition and previous cardiovascular disease.

"Our research identifies fatigue as an important bio-alarm to predict cardiovascular events in dialysis patients, particularly those who are well-nourished and healthy-looking," study co-leader Dr. Hidenori Koyama of Osaka City University Graduate School of Medicine, said in a news release.

The study will appear in an upcoming issue of the Clinical Journal of the American Society of Nephrology.

Koyama and colleagues said further research is needed to learn more about the relationship between fatigue in dialysis patients and increased risk of cardiovascular events.

"Another important question is whether interventions for fatigue will be effective in preventing cardiovascular events," Koyama added.

More information

The National Kidney Foundation explains how dialysis patients can keep their hearts healthy  .

TUESDAY, Feb. 23 (HealthDay News) -- The newest heart imaging CT technology exposes patients to as much as 91 percent less radiation than standard CT scanning, researchers say.

"Coronary CT angiography has generated great enthusiasm in recent years, due to its diagnostic accuracy in assessing patients with known or suspected coronary artery disease. However, that enthusiasm has been tempered by concern about the potentially high radiation dose received by patients," Dr. Andrew J. Einstein, an assistant professor of clinical medicine in radiology and director of cardiac CT research at Columbia University Medical Center, said in a news release.

Einstein and colleagues compared radiation exposure with a standard 64-detector row CT scanner -- which can image 4 centimeters of the heart at a time -- and a 320-detector row volume CT scanner, which can image 16 centimeters -- the entire length of the heart -- in a single rotation and within a single heartbeat.

"By imaging the entire heart in one piece, volume scanning eliminates artifacts due to seams or gaps between image sections. Moreover, the X-ray tube is left on for only a brief duration, as little as 0.35 seconds," Einstein said in a news release from the Radiological Society of North America.

The study, published in the March issue of Radiology, found that the effective radiation dose was 35.4 millisieverts for a 64-detector row helical scan and 4.4 mSv for a 320-detector row volume scan.

"As CT technology advanced from 16- to 64-slice capabilities, the radiation dose went up significantly. Today, technology development is going in the opposite direction, reducing radiation exposure," Einstein said.

More information

The U.S. Food and Drug Administration has more about CT scans.

WEDNESDAY, Jan. 20 (HealthDay News) -- Heart and lung function appear to be intimately intertwined, so that even mild cases of chronic lung disease affect the heart's ability to pump blood, a new study finds.

"It suggests that a larger subset of heart failure may be due to lung disease," said Dr. R. Graham Barr, an assistant professor of medicine and epidemiology at Columbia University Medical Center and lead author of a report in the Jan. 21 issue of the New England Journal of Medicine.

It's long been known that severe chronic obstructive pulmonary disease (COPD) can have damaging effects on the heart, Barr said. But the new report, which covered 2,816 people in a long-running lung study, shows that "even a mild decrease in lung function affects heart function," he said.

Barr and his colleagues used two imaging techniques, computed tomography (CT) scanning and MRI, to measure both heart and lung structure and function. "We observed a linear straight-line relationship," Barr said.

The probable cause of the loss of ability to pump blood, he said, is a reduced blood supply to the heart.

COPD is the fourth-leading cause of death in the United States. One form of COPD is emphysema, in which lung tissue is destroyed. Another form is chronic obstructive bronchitis, which causes narrowed airways, a persistent cough and excess mucus production. Lung disease is strongly associated with smoking.

The immediate application of the finding to medical practice would be in diagnosis, Barr said. "Our study was not of possible intervention," he said. "Future studies will show how much treatment of the lung affects the heart and how much treatment of the heart affects the lung."

Barr has begun such a study, which he said is in an early stage. "These problems take a long time to develop, and so they take a long time to study," he said. The study is expected to last several years.

Meanwhile, physicians seeing people who report such lung problems as shortness of breath might consider testing their heart function, Barr said.

The report is an offshoot of a large study, supported by the U.S. National Heart, Lung and Blood Institute, that focused on finding early stages of heart, lung and blood diseases.

"What makes it a novel finding is that just a slight degree of lung disease can have an overall impact on cardiovascular health," said James P. Kiley, director of the institute's lung disease division. "What we are seeing here is the ability to bring the two conditions together."

There is a distinct benefit in looking at the two conditions together, Kiley explained. "Understanding cardiovascular disease might help understand lung disease and vice versa," he said. "We can put more emphasis on the possibility that these two do have a link and that the link needs to be explored further, even in the clinical assessment of a patient."

More information

The U.S. National Heart, Lung and Blood Institute has more on COPD.