Wii-Based and Supervised Exercise Training Decrease Falls Risk in Older Adults with Type 2 Diabetes

Abstract

Loss of balance resulting in falls is a serious health issue for older persons with type 2 diabetes (T2D). One intervention shown to produce benefits for these individuals is various types of exercise training. However, motivation is commonly cited as a barrier to consistent physical activity participation in unsupervised conditions. Interactive video games, such as the Nintendo Wii system, have been viewed as an innovative tool for engaging individuals in activity at home. PURPOSE: To assess the differences between supervised and unsupervised (using the Nintendo Wii) exercise training aimed at improving balance, reaction time, lower limb strength, and falls risk in older adults with T2D. METHODS: 47 older adults with T2D participated in 12 weeks of training: 32 (mean age 67.7 + 5 yr) completed supervised training (ST) while 15 (mean age 66.3 + 5 yr) completed unsupervised Wii training. ST sessions (40 min each, 3 times a week) consisted of lower limb stretches followed by leg, abdominal, and lower back exercises. The Wii training group completed three 40-min sessions on the Wii balance board per week. The Wii-based exercises were self-selected to emphasize balance and postural control. Prior to and following training, assessments of lower limb strength (i.e., isometric knee extension and flexion), falls risk (using the Physiological Profile Assessment), balance, postural coordination, vision, proprioception and reaction time were performed. RESULTS: Following training, participants in both the ST and Wii groups showed a significant decline in overall falls risk (ST, 0.59 + 0.12 to 0.22 + 0.14; Wii, 0.33 + 0.13 to 0.17 + 0.11; p < 0.05). Falls risk reductions were driven by significant improvements in knee extension (ST, 31.5 kg to 36.4 kg; Wii, 31.1 to 34.3 kg), knee flexion (ST, 16.9 to 19.3 kg; Wii, 17.0 to 18.3 kg), faster reaction times (ST, 278 to 247 ms; Wii, 244 to 225 ms) and improved postural coordination (ST, 13.4 to 9.1 errors; Wii, 9.7 to 6.5 errors). CONCLUSION: Both ST and unsupervised Wii exercise training interventions led to a reduction in falls risk in older adults with T2D, accompanied by increases in leg strength, faster reaction times, and improved balance coordination. Thus, both supervised and unsupervised exercise may lead to improvements in falls risk in older adults with T2D.