A Pilot Study of Wii Fit Exergames to Improve Balance in Older Adults
ABSTRACT To determine the safety and feasibility of using Nintendo Wii Fit exergames to improve balance in older adults.
Seven older adults aged 84 (5) years with impaired balance (Berg Balance Scale [BBS] score < 52 points) were recruited from 4 continuing care retirement communities to participate in a single group pre- and postevaluation of Wii Fit exergames. Participants received individualized instructions (at least 5 home visits) on playing 4 exergames (basic step, soccer heading, ski slalom, and table tilt) and were asked to play these games in their homes at least 30 minutes 3 times per week for 3 months and received weekly telephone follow-up. They also completed a paper log of their exergame play and rated their enjoyment immediately after each session. Participants completed the BBS, 4-Meter Timed Walk test, and the Physical Activity Enjoyment Scale at baseline and 3 months. Semistructured interviews were conducted at the 3-month evaluation.
Participants safely and independently played a mean of 50 sessions, median session duration of 31 minutes. Two of the games were modified to ensure participants' safety. Participants rated high enjoyment immediately after exergame play and expressed experiencing improved balance with daily activities and desire to play exergames with their grandchildren. Berg Balance Scores increased from 49 (2.1) to 53 (1.8) points (P = .017). Walking speed increased from 1.04 (0.2) to 1.33 (0.84) m/s (P = .018).
Use of Wii Fit for limited supervised balance training in the home was safe and feasible for a selected sample of older adults. Further research is needed to determine clinical efficacy in a larger, diverse sample and ascertain whether Wii Fit exergames can be integrated into physical therapy practice to promote health in older adults.
- SourceAvailable from: Sangeetha Madhavan
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- "The Nintendo Wii Fit (Nintendo Wii Sports, Nintendo, Redmond, WA) is a simple and affordable mode of VR gaming technology, and is an excellent alternative to some of the more expensive VR systems. Balance training using the Wii Fit gaming system is reported to improve balance and self-perceived confidence in older adults and individuals with Parkinson's disease (Agmon et al., 2011; Bateni, 2012; Esculier et al., 2012). Despite the increasing number of applications using the Wii Fit balance board for neurorehabilitation, there remains a paucity of research directly investigating the neural mechanisms supporting its use in stroke rehabilitation. "
ABSTRACT: ABSTRACT The objective was to examine the effectiveness of a 3-week balance training program using the Nintendo Wii Fit gaming system (Nintendo Wii Sports, Nintendo, Redmond, WA) on lower limb corticomotor excitability and other clinical measures in chronic stroke survivors. Ten individuals diagnosed with ischemic stroke with residual hemiparesis received balance training using the Wii Fit for 60 min/day, three times/week, for three weeks. At the end of training, an increase in interhemispheric symmetry of corticomotor excitability of the tibialis anterior muscle representations was noted (n = 9). Participants also showed improvements in reaction time, time to perform the Dual Timed-Up-and-Go test, and balance confidence. The training-induced balance in corticomotor excitability suggests that this Wii-based balance training paradigm has the potential to influence neural plasticity and thereby functional recovery.Journal of Motor Behavior 11/2014; 47(3):1-11. DOI:10.1080/00222895.2014.971699 · 1.42 Impact Factor
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- "In addition, due to their easy use and relative low costs they could be deployed in the homes of older people with possible significant cost savings . However, further research is required in this area as only two studies have applied systems within older people’s homes [43, 58] and no studies have conducted cost-effectiveness, cost–utility or cost–benefit analyses of their interventions. "
ABSTRACT: It is well-known physical exercise programs can reduce falls in older people. Recently, several studies have evaluated interactive cognitive-motor training that combines cognitive and gross motor physical exercise components. The aim of this systematic review was to determine the effects of these interactive cognitive-motor interventions on fall risk in older people. Studies were identified with searches of the PubMed, EMBASE, and Cochrane CENTRAL databases from their inception up to 31 December 2013. Criteria for inclusion were a) at least one treatment arm that contained an interactive cognitive-motor intervention component; b) a minimum age of 60 or a mean age of 65 years; c) reported falls or at least one physical, psychological or cognitive fall risk factor as an outcome measure; d) published in Dutch, English or German. Single case studies and robot-assisted training interventions were excluded. Due to the diversity of populations included, outcome measures and heterogeneity in study designs, no meta-analyses were conducted. Thirty-seven studies fulfilled the inclusion criteria. Reporting and methodological quality were often poor and sample sizes were mostly small. One pilot study found balance board training reduced falls and most studies reported training improved physical (e.g. balance and strength) and cognitive (e.g. attention, executive function) measures. Inconsistent results were found for psychological measures related to falls-efficacy. Very few between-group differences were evident when interactive cognitive-motor interventions were compared to traditional training programs. The review findings provide preliminary evidence that interactive cognitive-motor interventions can improve physical and cognitive fall risk factors in older people, but that the effect of such interventions on falls has not been definitively demonstrated. Interactive cognitive-motor interventions appear to be of equivalent efficacy in ameliorating fall risk as traditional training programs. However, as most studies have methodological limitations, larger, high-quality trials are needed.BMC Geriatrics 09/2014; 14(1):107. DOI:10.1186/1471-2318-14-107 · 1.68 Impact Factor
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- "In 2008, Nintendo Corporation (Kyoto, Japan) launched the Nintendo Wii Balance Board (NWBB) primarily intended as a toy for kids. However, not long after the launch, researchers worldwide started exploring the NWBB for additional purposes than solely entertainment, and found that the NWBB could be used as a training device –, a physical examination tool ,  and a prediction tool . A recent study reported that the Nintendo Wii Stillness test was highly reproducible in community-dwelling older adults when assessing standing balance . "
ABSTRACT: the purpose of this study was to explore if the Nintendo Wii Stillness test could differentiate between age and gender matched fallers and non-fallers. 20 older fallers and 23 older non-fallers performed three trials of the Stillness balance test. Results showed a ~23% difference in the scores of the two groups (p=0.007). The Stillness test therefore appears to be able to differentiate age-and gender matched fallers and non-fallers. In addition, the test is low-cost, time-efficient, and widely available across the world and could therefore become a good alternative to existing tools/scales for assessment of standing balance.2nd International Conference on NeuroRehabilitation, Aalborg, Denmark; 06/2014