Wii Fit Games Research Articles

The Effects of Nintendo Wii Fit on Postural Balance Control Training in the Geriatric Population: A Review.

Elderly populations who engage in consistent, moderate-intensity exercise are more physically active and have better health than elders who have a sedentary lifestyle. Ageing causes the quality and number of muscle fibres to decline, leaving them with less endurance and ability to effectively work in synchronization and less strength and stamina to support weight or keep a sound body system. Medical practitioners often use the word "balance" across many therapeutic disciplines. Balance is commonly used in conjunction with other ideas like stability and postural control. The capacity of the physiological systems to keep the centre of mass within the base of support during static and dynamic postures and to govern physical alignment in an upright position is known as "balance." Impaired balance has a wide range of effects that can harm physical functionality. Falls in the elderly can result in hip fractures and significant morbidity and mortality. Balance dysfunction is one of the primary reasons behind decreased mobility and postural control in the elderly. It mainly affects the ability to walk and to maintain balance control in everyday life. Virtual reality (VR) can be defined as an interaction model between humans and computers that allows conventional computer-based training. It is a novel and expanding technology combining various characteristics like interactivity, independence, and rehabilitation training. These technologies replicate a seemingly natural environment. A fun and engaging aspect of VR technology is the Wii Fit games. These are enjoyable versions of the fundamental exercise and are widely used. A physiotherapy intervention programme can be structured using Wii Fit games to perform balance exercises. These games are widely used for balance training in the geriatric population.

Role Wii Fit exer-games in improving balance confidence and quality of life in elderly population.

To determine the effects of Wii Fit exer-gaming on balance confidence, quality of life and fall risk in elderly population. The double-blind randomised control trial was conducted at Kulsum International Hospital, Islamabad, Pakistan, from July 31 to October 30, 2018, and comprised vitally stable, physically independent subjects of either gender aged 60 years and above, having no serious systemic disease. The subjects were randomly allocated into experimental group A and control group B using the concealed envelope method. After baseline assessment, group A received Wii fit gaming, while group B received balance training for 30 minutes twice a week for 8 weeks. Activities balance confidence (ABC), European Quality of Life-5 Dimensions (EQ 5D-5L), timed up and go (TUG) and Fukuda were used to assess the impact of the intervention. Data was analysed using SPSS 21. Of the 90 subjects, 83(92.2%) completed the study. There were 51(62%) males and 32 (38%) females; and 45(50%) in each of the two groups. Group A had 42(50.6%) subjects with 26(62%) males and 16(38%) females, and 41 were in group B, with 25(61%) males and 16(39%) females. Balance confidence improved in both groups, but it was significantly higher in group A (p<0.001). Mobility, self-care, usual activities, pain/discomfort, anxiety/depression as well as timed up and go and Fukuda showed significantly more improvement in group A compared to group B (p<0.05). Wii fit was found to have the potential to improve balance confidence and quality of life, reducing the fall risk among the elderly. IRCT20180417039344N1 by Iranian Registry of Clinical Trials.

Wii Fit Gaming System—How to Select among Balance Exercise and Measurement Tools

Wii Fit Gaming System—How to Select among Balance Exercise and Measurement Tools

Effects of Nintendo Wii fit game training on balance among Lebanese older adults.

Falls are the second leading cause of accidental death, with persons older than 65years being the most affected. Moreover, gait- and balance-related problems represent the most consistent predictors of future falls. The aim was to determine the effects of Wii fit game training on dynamic and static balance among Lebanese older adults. A randomized-controlled trial was conducted over a period of 8weeks, where institutionalized older adults with no history of falls were randomized into two groups. The participants of each group were carefully followed up during the intervention and data collection periods. The intervention group was trained for standing balance during a 40-min session, starting with the "Soccer Heading" game during the first 4 weeks, followed by the "Table Tilt" game for the remaining 4 weeks. Timed up-and-go (TUG) test and the Nintendo Wii Balance Board were used to measure the dynamic and static balance, respectively, both at baseline and post-intervention. Sixty-four participants recruited from both, the Tyre and Saida districts were enrolled in the study. Within-group comparison of TUG test values between baseline and post-intervention; both groups showed an extremely significant difference (P = 0.000). Similarly, the between-group comparison showed a significant difference (P = 0.013). Concerning the center of pressure measures, only the intervention group showed a very significant improvement between baseline and post-intervention measures (P = 0.002). Wii fit balance training is a valid method for improving both dynamic and static balance among Lebanese older adults.

Cognitive-motor exergaming for reducing fall risk in people with chronic stroke: A randomized controlled trial.

Dual-task (simultaneous motor and cognitive task) (DT) training via virtual-reality exergaming is known to benefit balance control post-stroke. However, the efficacy of such training on DT balance control (volitional and reactive) and cognitive (executive function and attention) domains associated with fall risk remains unclear. We evaluated the efficacy of cognitive-motor exergame training (CMT) (Wii-fit games in conjunction with cognitive tasks) for improving balance control (volitional and reactive) and cognition (executive function and attention) among people with chronic stroke (PwCS). Hemiparetic, ambulatory PwCS were randomly assigned to either CMT (n = 12) or conventional training (CT) (n = 12) and underwent six weeks of high-intensity, tapered balance training. The CMT group performed Wii-fit games in conjunction with cognitive tasks, while CT group underwent customized, progressive balance training. Performance under DT conditions on Limits of Stability (volitional) and Slip-Perturbation (reactive) tests, and letter-number sequencing (cognition) determined the efficacy of CMT. Post-intervention, under DT reactive conditions, CMT group improved both motor and cognition, while the CT group improved motor alone. Under DT volitional conditions, motor performance improved only in CMT group. Cognitive-motor exergaming appears to be effective for improving balance control and cognition and could be implemented in clinical stroke rehabilitation settings.

Effects of the Nintendo Wii Fit Game Training on Balance

Effects of the Nintendo Wii Fit Game Training on Balance

The Influence of Active Gaming on Cardiorespiratory Fitness in Black and Hispanic Youth.

Youth in the United States have low levels of cardiorespiratory fitness, a risk factor for childhood obesity. Lower levels of physical fitness for black and Hispanic youth contribute to health disparities. In this feasibility study, we examined active video games (AVGs) as a tool to improve fitness and attitudes toward physical activity during early adolescence. A 6-week AVG program took place in a youth development program in a high-poverty neighborhood in New York City. Youth aged 10 to 15 years (50% overweight or obese) participated in 2 fitness tests and completed surveys that captured barriers to physical activity pre- and postintervention. Each week, participants played Wii Fit games for 30 minutes. Participants improved the number of sit-ups and step-ups they completed from pre- to postintervention (p < .05). Participants also increased their self-efficacy, intention to exercise and perceived social support to exercise (p < .05). Youth reported a high level of enjoyment and perceived Wii Fit as ways to increase physical fitness and increase their physical activity. AVGs may be a viable alternative exercise program to increase physical activity for black and Hispanic youth living in poverty-impacted neighborhoods.

The effects of virtual reality on the rehabilitation of patients with knee OA: A randomized controlled clinical trial

Knee OA is one of the most prevalent orthopedic diseases in the elderly population, with a degenerative and progressive character that affects the articular cartilage, limiting the articular range of motion (ROM) due to rigidity and causing important functional restrictions. Virtual reality (VR) is one of the instruments that can help in the rehabilitation process of patients, motivating them and enabling more assertive movements and exercises. Ninety patients (65 women and 25 men) between 50 and 70 years old, with a medical diagnosis of OA in at least one knee participated in the study. After completing the WOMAC and Lequesne questionnaires, they were evaluated for pain and muscular strength. The volunteers signed the consent term and were then randomly divided, using opaque, sealed envelopes, into 3 groups: control group - performed a conventional physiotherapy program with aerobic and muscle strengthening exercises; experimental group 1 (Wii) - in addition to the conventional program used Nintendo's Wii Fit games; experimental group 2 (Kinect) - complemented the conventional treatment with the Xbox Kinect video game system. It was observed that, in general, the three study groups demonstrated statistically significant improvement ( P < 0.05) in relation to pain and muscular strength. The groups with inclusion of the VR resources only presented better results than the control group in the function dimension of the WOMAC questionnaire. The methodological conditions used in the study suggest that virtual reality as an additional instrument in rehabilitation programs for patients with knee OA was better than the control group only in the function dimension of the WOMAC questionnaire.

A Narrative Synthesis of Nintendo Wii Fit Gaming Protocol in Addressing Balance Among Healthy Older Adults: What System Works?

Balance is crucial in performing functional tasks particularly among older adults. Exergaming is gaining attention as a novel approach to enhance balance in a number of clinical populations. The aim of this review was to synthesize and present published evidence for Nintendo Wii Fit™ gaming system protocols. These include game preference, intervention setting, and exercise dosage for improving balance in healthy older adults. Commonly used outcome measures were also identified. A literature search was developed using the PICOS strategy using keywords such as "older adult," "Nintendo Wii Fit," "exergaming," and "balance" in the databases: MEDLINE, PubMed, EMBASE, CINAHL, Scopus, Science Direct, and Web of Science. Sixteen articles were included with participants (n = 491) mostly female (69%), and mean age ranged between 71 and 85 years old. Participants were recruited mainly from the community. The most commonly used Wii Fit games were Table tilt, Soccer Heading, Ski Slalom, and Ski jump, performed three times per week, with a duration of 30 minutes per session for 6 weeks. Berg Balance Scale, Timed Up and Go Test, and Centre of Pressure were the most commonly used outcome measures. Wii Fit exergames can be a potential alternative to improve balance if safety and technical procedures are provided. With conflicting and mechanism-based evidence on dosage presented, exergaming parameters require further research before firm recommendations can be made. Clinically, effective dosage is an important component in any type of interventions, and exergaming should not be an exception.

Effects of Nintendo Wii-Fit® video games on balance in children with mild cerebral palsy.

This study compared the effects of Nintendo Wii-Fit® balance-based video games and conventional balance training in children with mild cerebral palsy (CP). This randomized controlled trial involved 30 ambulatory pediatric patients (aged 5-18 years) with CP. Participants were randomized to either conventional balance training (control group) or to Wii-Fit balance-based video games training (Wii group). Both group received neuro-developmental treatment (NDT) during 24 sessions. In addition, while the control group received conventional balance training in each session, the Wii group played Nintendo Wii Fit games such as ski slalom, tightrope walk and soccer heading on balance board. Primary outcomes were Functional Reach Test (forward and sideways), Sit-to-Stand Test and Timed Get up and Go Test. Nintendo Wii Fit balance, age and game scores, 10 m walk test, 10-step climbing test and Wee-Functional Independence Measure (Wee FIM) were secondary outcomes. After the treatment, changes in balance scores and independence level in activities of daily living were significant (P < 0.05) in both groups. Statistically significant improvements were found in the Wii-based game group compared with the control group in all balance tests and total Wee FIM score (P < 0.05). Wii-fit balance-based video games are better at improving both static and performance-related balance parameters when combined with NDT treatment in children with mild CP.

Impact of Incentive Therapy on Postural Control in Burn Survivors

Background: Burn has a causative factor in avoidant behaviors and lack of postural control. Objectives: To guide the rehabilitation team making decision regarding the use of incentive therapy via Wii interactive video games in physical therapy practice for burned patients. Materials and methods: The traditional (control) group received a physical therapy session including positioning, range of motion exercises, stretching exercise for lower limb muscles, and daily walking. The study group (Wii group) received previous physical therapy program followed by 15 minutes of Wii Fit gaming activities. Main outcome measures: Static and dynamic balance assessment using Biodex Balance system, Timed-Up and Go test, Activities-Specific Balance Confidence Scale and Numeric Pain Rating Scale. Results: Statistically significant differences were found between the study and control groups; for the favor of patients practiced the Wii interactive video game. Conclusions: Incentive therapy via active participation of patients using Wii Fit is potentially acceptable as an adjunct to the physical therapy intervention for burned patients aiming to improve postural control.

The effect of exergames on functional strength, anaerobic fitness, balance and agility in children with and without motor coordination difficulties living in low-income communities

Children with Developmental Coordination Disorder (DCD) are physically less active, preferring more sedentary behavior and are at risk of developing health problems or becoming overweight. 18 children (age 6–10years) with lower levels of motor coordination attending a primary school in a low-income community in South Africa (score on Movement Assessment Battery for Children Second edition equal to or below the 5th percentile) were selected to participate in the study and were age-matched with typically developing peers (TD). Both groups of children engaged in 20min of active Nintendo Wii Fit gaming on the balance board, twice a week for a period of five weeks. All children were tested before and after the intervention using the lower limb items of the Functional Strength Measurement, the 5×10 meter sprint test, the 5×10 meter slalom sprint test, and the Balance, Running speed and Agility subtest of the Bruininks Oseretsky Test of Motor Proficiency 2nd edition (BOT-2).After intervention, both groups of children improved in functional strength and anaerobic fitness. The magnitude of these changes was not related to participant’s motor coordination level. However, differences in change between the TD and DCD group were apparent on the motor performance tests; children with DCD seemed to benefit more in balance skills of the BOT-2, while the TD children improved more in the Running speed and Agility component of the BOT-2. Compliance to the study protocol over 5weeks was high and the effect on physical functioning was shown on standardized measures of physical performance validated for children with and without DCD.

Changes in dynamic balance control over time in children with and without Developmental Coordination Disorder

The aim of this study was to examine differences in underlying adaptations of dynamic balance in children with and without Developmental Coordination Disorder (DCD) during a Wii Fit game and to measure changes over time and after intervention.Twenty-eight children with DCD and 21 typically developing (TD) children participated in the study. Analyses of force plate variables showed that the TD group initially used a longer path length for the ski slope descent and tended toward more variation in Center of Pressure (CoP) displacement in lateral direction than the children with DCD. In contrast, the TD group showed a trend of fewer reversals per cm in both AP and lateral direction. After the nonintervention period, the TD group improved performance by decreasing the path length, while the DCD group improved by increasing the path length and by decreasing the number of reversals. After intervention, no changes were found in sway characteristics. Individual analyses within the DCD group showed that the path length per run fell more often within the 95% confidence Interval of the faultless runs. In conclusion both TD and DCD children modify the underlying kinetics of dynamic balance control, but in different ways and both lead to better performance.

Feasibility of a Low-Cost, Interactive Gaming System to Assess Balance in Older Women.

The use of low-cost interactive game technology for balance rehabilitation has become more popular recently, with generally good outcomes. Very little research has been undertaken to determine whether this technology is appropriate for balance assessment. The Wii balance board has good reliability and is comparable to a research-grade force plate; however, recent studies examining the relationship between Wii Fit games and measures of balance and mobility demonstrate conflicting findings. This study found that the Wii Fit was feasible for community-dwelling older women to safely use the balance board and quickly learn the Wii Fit games. The Ski Slalom game scores were strongly correlated with several balance and mobility measures, whereas Table Tilt game scores were not. Based on these findings, the Ski Slalom game may have utility in the evaluation of balance problems in community-dwelling older adults.

Six Weeks of Unsupervised Nintendo Wii Fit Gaming Is Effective at Improving Balance in Independent Older Adults

Objective: To determine the effectiveness of unsupervised Nintendo Wii Fit balance training in older adults. Methods: Forty-one older adults were recruited from local retirement villages and educational settings to participate in a six-week two-group repeated measures study. The Wii group (n = 19, 75 ± 6 years) undertook 30 min of unsupervised Wii balance gaming three times per week in their retirement village while the comparison group (n = 22, 74 ± 5 years) continued with their usual exercise program. Participants’ balance abilities were assessed pre- and postintervention. Results: The Wii Fit group demonstrated significant improvements (P < .05) in timed up-and-go, left single-leg balance, lateral reach (left and right), and gait speed compared with the comparison group. Reported levels of enjoyment following game play increased during the study. Conclusion: Six weeks of unsupervised Wii balance training is an effective modality for improving balance in independent older adults.

Effects of interactive games on motor performance in children with spastic cerebral palsy.

[Purpose] Motor control and muscle strength impairments are the prime reasons for motor behavior disorders in children with spastic cerebral palsy. These impairments lead to histological changes in muscle growth and the learning of motor skills. Therefore, such children experience reduced muscle force generation and decreased muscle flexibility. We investigated the effect of training with Nintendo Wii Fit games on motor performance in children with spastic cerebral palsy. [Subjects and Methods] Forty children with cerebral palsy spastic diplegia aged 6–10 years diagnosed with level-3 functional capabilities according to the Gross Motor Classification System (GMFCS) were enrolled. Participants were divided randomly into equal groups: group (A) that practiced with the Nintendo Wii Fit game for at least 20 minutes/day for 12 weeks and group (B) that underwent no training (control group). The Movement Assessment Battery for Children-2 (mABC-2) was used to assess motor performance, because it mainly involves motor tasks very similar to those involved in playing Nintendo Wii Fit games, e.g., goal-directed arm movements, balancing, and jumping. [Results] There were significant improvements in the subscales of the motor performance test of those who practiced with the Nintendo Wii, while the control group showed no significant changes. [Conclusion] Using motion interactive games in home rehabilitation is feasible for children with cerebral palsy.

Effect of Wii-Based Balance Training on Corticomotor Excitability Post Stroke

ABSTRACTThe 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.

The effect of the Nintendo Wii Fit on exercise capacity and gait in an elderly woman with CREST syndrome

Background/Purpose: Physical deconditioning and impaired balance and gait are common barriers to exercise in frail older adults. This case report describes the efficacy of Nintendo Wii Fit exercises in improving functional capacity, exercise tolerance, strength and balance in an elderly woman with CREST syndrome and multiple chronic conditions. Case description: A sedentary 77-year-old woman with: scleroderma (CREST syndrome) and secondary Sjögren's syndrome; pulmonary hypertension; coronary artery disease; interstitial lung disease; and tremor. The patient could ambulate with a cane and had a high risk of falling. Methods: The participant completed three 30-minute sessions of Wii Fit exercises per week for 12 weeks. The exercises included step aerobics, marching and interactive games to develop balance, weight transfer and upper and lower body strength. Results: Substantial improvements were seen in the following: 6-minute walk test (6MWT) (100%); Timed Up and Go (TUG) (5.3%); 30-second sit to stand (25%); hand grip strength (right 21%; left 8.6%); ankle plantarflexion (right 16.7%; left 33.3%) and dorsiflexion (right 125%; left 88.9%), Tinetti Balance and Gait Assessment (balance score 35.5%; falls efficacy scale score 21.4%); resting systolic blood pressure (5.1%); and oxygen saturation (3.3%). The average movement of centre of pressure decreased post-intervention, but average velocity increased. Conclusions: Specific Wii Fit games may improve health, exercise capacity, mobility, balance and fall risk in older adults affected with CREST and associated severe cardiopulmonary symptoms.

No. 98 A Randomized Comparison Trial of Balance Training Using Wii Fit Games and Conventional Weight Shifting Therapy in People With Chronic Stroke

PM&RVolume 6, Issue 8S2 p. S115-S115 Poster Presentation No. 98 A Randomized Comparison Trial of Balance Training Using Wii Fit Games and Conventional Weight Shifting Therapy in People With Chronic Stroke Jen-Wen Hung, Jen-Wen HungSearch for more papers by this authorChiung-Xia Chou, Chiung-Xia ChouSearch for more papers by this authorYen-Wei Hsieh, Yen-Wei HsiehSearch for more papers by this authorWen-Chi Wu, Wen-Chi WuSearch for more papers by this author Jen-Wen Hung, Jen-Wen HungSearch for more papers by this authorChiung-Xia Chou, Chiung-Xia ChouSearch for more papers by this authorYen-Wei Hsieh, Yen-Wei HsiehSearch for more papers by this authorWen-Chi Wu, Wen-Chi WuSearch for more papers by this author First published: 18 September 2014 https://doi.org/10.1016/j.pmrj.2014.08.230Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume6, Issue8S28th World Congress of the International Society of Physical & Rehabilitation Medicine (ISPRM)August 2014Pages S115-S115 RelatedInformation

Ride ‘em cowboy! The therapeutics of virtual reality technology and simulation

Linked Comment: Yoo et al. Int J Clin Pract 2014; 68: 941–9. Chronic low back pain is ubiquitous. Although pharmacotherapy can provide symptomatic relief 1, fundamental changes in body composition and muscle strength may more durably address this problem. Physical activities like swimming, walking and cycling, practiced at moderate intensity can help to maintain fitness and control pain 2, 3. However, not all physical activities are easily accessible, or free of safety issues. An example would be horseback riding. In this issue of the International Journal of Clinical Practice, Yoo et al. 4 describe a horse simulator machine that provides real horse movement and is intended to stimulate a higher level of posture enhancement and improve motor function, strength and muscle size. An 8-week clinical trial was conducted with 47 men with chronic low back pain who were randomised to a horse simulator riding group or a control group. Pain, body composition and isokinetic trunk strength were measured. Horse simulator exercise significantly reduced pain scores and enhanced isokinetic torques of the trunk. There was also significantly increased muscle mass and decreased fat mass in the participants in the horse simulator riding group. During real horseback riding, responding to a changing environment encourages adaptive behaviours or movement strategies, reducing the displacement of the rider's centre of gravity and keeping themselves on the moving horse 4. Adjusting to the horse simulator's movements also involves the use of these same muscles and joints. Thus, as the authors have noted, a horse simulator provides the benefits of a real horse including rhythmical movement, except the warmth of the horse's body. However, the latter can also be simulated if desired. Remaining missing are the care and feeding (and cleaning up after) the real horse. Simulated horse riding is a form of ‘virtual reality’, a technology that has usually been associated with entertainment rather than therapeutics. Yoo et al. have reported on a rather sophisticated machine that only superficially resembles the amusement arcade machines that simulate skiing or other sports. The technology is reminiscent also of the Nintendo Wii Fit game with balance board (http://wiifit.com/). Repurposing entertainment technology for therapeutic use is anticipated to be more common as technology continues to advance. In development is a headset that delivers a three-dimensional immersive experience that is perhaps neurologically indistinguishable from the outside world 5. This may be a real game-changer, and although intended for actual games, may also have medical applications. No disclosures relevant to the subject of this editorial other than being married to a physiatrist and having a lifelong fascination with technology.