Wii Fit Games Research Articles

Impaired visually guided weight-shifting ability in children with cerebral palsy.

The ability to control voluntary weight shifting is crucial in many functional tasks. To our knowledge, weight shifting ability in response to a visual stimulus has never been evaluated in children with cerebral palsy (CP). The aim of the study was (1) to propose a new method to assess visually guided medio-lateral (M/L) weight shifting ability and (2) to compare weight-shifting ability in children with CP and typically developing (TD) children. Ten children with spastic diplegic CP (Gross Motor Function Classification System level I and II; age 7-12 years) and 10 TD age-matched children were tested. Participants played with the skiing game on the Wii Fit game console. Center of pressure (COP) displacements, trunk and lower-limb movements were recorded during the last virtual slalom. Maximal isometric lower limb strength and postural control during quiet standing were also assessed. Lower-limb muscle strength was reduced in children with CP compared to TD children and postural control during quiet standing was impaired in children with CP. As expected, the skiing game mainly resulted in M/L COP displacements. Children with CP showed lower M/L COP range and velocity as compared to TD children but larger trunk movements. Trunk and lower extremity movements were less in phase in children with CP compared to TD children. Commercially available active video games can be used to assess visually guided weight shifting ability. Children with spastic diplegic CP showed impaired visually guided weight shifting which can be explained by non-optimal coordination of postural movement and reduced muscular strength.

Perceptions of using videogames in rehabilitation: a dual perspective of people with multiple sclerosis and physiotherapists

Purpose: Our aim was to describe experiences of using Nintendo Wii Fit™ for balance exercise, from the perspectives of patients with multiple sclerosis (MS) and their physiotherapists (PT). Methods: Individual interviews with 15 patients with MS were conducted, recruited from a multi-centre study investigating the effects of balance exercising using Wii Fit. We also conducted a single focus group interview with nine PT involved in the study. The interviews were audio-recorded, transcribed, and analysed using content analysis. Results: Both patients and PT said that exercising with Wii Fit games was fun, and that it challenged the patients’ physical and cognitive capacities. The competitive content in the games provided motivation to continue playing. Patients and PT reported improved body control and, more importantly, positive effects on balance and walking in daily life. The PT regarded Wii training as an effective alternative to other balance training, but some felt unsure in how to manage the video game. The patients regarded Wii training as a possible home training solution. Conclusions: Patients with MS and their PT considered Wii Fit exercises to be fun, challenging, and self-motivating. Exercising with Wii games can address balance impairments in MS, and can be performed at home as well as in rehabilitation settings.Implications for RehabilitationNintendo Wii Fit™ can be used as a fun and challenging way to perform balance exercises.The competitive content embedded in the games triggers continued playing and exercising.The positive effect on balance control can improve standing and walking in everyday activities.

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

To determine the effectiveness of unsupervised Nintendo Wii Fit balance training in older adults. 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. 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. Six weeks of unsupervised Wii balance training is an effective modality for improving balance in independent older adults.

Assessment of the Feasibility of the Nintendo Wii Balance Board as an Intervention Method For Balance Rehabilitation with Lower-limb Amputees

Lower-limb amputations have a major impact on balance and functional skills, which can be limited by rehabilitation. The Wii Balance Board (WBB) with its Wii Fit game (WFg) is often used in clinical settings with lowerlimb amputees but there is little research concerning its efficacy in improving static and dynamic balance. This study aims to assess the feasibility of using the Nintendo Wii Balance Board (WBB) and Wii Fit game (WFg) for balance rehabilitation with lower-limb amputees. A pre-/post-intervention pilot study design with no control group was used. Participants received 5 WBB and WFg rehabilitation sessions / week for 8 weeks. The length of the training sessions gradually increased from 10 to 30 minutes. Clinical outcomes were measured before (T1) and after (T2) the program and consisted of: 1) walking (L-test), 2) function and balance (Amputee Mobility Predictor [AMPPRO]), 3) satisfaction (Health Care Satisfaction Questionnaire [HCSQ]), 4) motivation (visual analog scale), and 5) quality of life (Trinity Amputation and Prosthesis Experience Scales [TAPES]). All participants (n=3) showed an improvement on all the clinical outcomes, except for the two functional tests, where one participant performed worse at T2 than T1. This pilot study demonstrated the feasibility of using the WBB and its WFg for balance rehabilitation with lower-limb amputees. Further research is needed to determine if this method is at least as effective as conventional interventions.

Corticomotor Excitability in Parkinson's Disease During Observation, Imagery and Imitation of Action: Effects of Rehabilitation Using Wii Fit and Comparison to Healthy Controls

Parkinson's disease (PD) is responsible for a progressive motor impairment. Wii Fit game represents an innovative treatment modality using external visual cueing, which can be used to help patients with PD in executing motor tasks and improving function. The objectives of this study were (1) to compare lower limb corticomotor activation in subjects with and without PD during action observation (OBS), motor imagery (IMAG), and imitation (IMIT), and (2) to evaluate the effects of a 6-week training program using Wii Fit on corticomotor excitability during these 3 conditions. Using transcranial magnetic stimulation, we assessed motor evoked potentials (MEPs) in Quadriceps Femoris (QF) and Soleus (SOL) muscles in 8 subjects with moderate PD (PD group) and 8 healthy subjects (HS group) before and after 6 weeks of training using Wii Fit during OBS, IMAG and IMIT of a mini-squat action. At baseline, PD showed significantly less MEPs in QF during OBS, IMAG and IMIT compared with HS. In SOL, MEPs were reduced in PD only during IMIT. Following training, PD increased QF MEPs during OBS, which was opposite to the decrease in QF MEPs noted in HS. During IMAG, increased MEPs were found only in PD for SOL. During IMIT, both groups significantly reduced MEPs in both QF and SOL. Subjects with PD may have improved their dual-task ability considering changes observed during OBS and IMIT. Visual cueing training using Wii Fit may provide an interesting rehabilitation method for PD.

Six weeks of unsupervised WiiFit game play improves balance and gait speed in independent older adults aged 65–84 years

Introduction: Age related deterioration in postural control and balance are associated with an increased risk of falling and fall related injuries. Around 30% of people aged 65 years or older living in the community fall every year. Previous research has shown that various forms of exercise, including balance training can improve balance and reduce the risk and incidence of falls. The Nintendo WiiFit and Wii balance board is a commercially available computer and software package with which player movements control game play.

Feasibility of Wii Fit training to improve clinical measures of balance in older adults

Background and purposeNumerous interventions have been proposed to improve balance in older adults with varying degrees of success. A novel approach may be to use an off-the-shelf video game system utilizing real-time force feedback to train older adults. The purpose of this study is to investigate the feasibility of using Nintendo’s Wii Fit for training to improve clinical measures of balance in older adults and to retain the improvements after a period of time.MethodsTwelve healthy older adults (aged >70 years) were randomly divided into two groups. The experimental group completed training using Nintendo’s Wii Fit game three times a week for 3 weeks while the control group continued with normal activities. Four clinical measures of balance were assessed before training, 1 week after training, and 1 month after training: Berg Balance Scale (BBS), Fullerton Advanced Balance (FAB) scale, Functional Reach (FR), and Timed Up and Go (TUG). Friedman two-way analysis of variance by ranks was conducted on the control and experimental group to determine if training using the Wii Balance Board with Wii Fit had an influence on clinical measures of balance.ResultsNine older adults completed the study (experimental group n = 4, control group n = 5). The experimental group significantly increased their BBS after training while the control group did not. There was no significant change for either group with FAB, FR, and TUG.ConclusionBalance training with Nintendo’s Wii Fit may be a novel way for older adults to improve balance as measured by the BBS.

An Exploratory Study Examining the Appropriateness and Potential Benefit of the Nintendo Wii as a Physical Activity Tool in Adults Aged ≥ 55 Years

This study investigates the physical exertion of playing the Nintendo Wii (R) (Wii) and determines the appropriateness and potential benefit of it as a physical activity tool for older adults. Twenty healthy adults (aged 61 +/- 6 years) took part in a single session using a selection of the Wii Sports and Wii Fit games. During the gameplay session, heart rate and perceived exertion were measured. Pre- and post-session, we investigated mood using the Positive and Negative Affect Schedule (PANAS) and cognitive function (i.e. aptitude, abstract reasoning and problem solving) using the test of non-verbal intelligence (TONI-IQ) and trail B tests. We also gathered subjective feedback from participants using semi-structured interviews and questionnaires. Three of the game activities (hula-hoop, rowing squat and leg extension) were identified to reach a moderate level of heart rate intensity, with one activity (jogging) corresponding to a vigorous level. We identified that post-session PANAS-positive subscale scores were greater than pre-session scores (P < 0.01). There was a reduction in the time to complete the TONI-IQ test from pre- to post-session (P < 0.05). Findings from these data identify that some Wii activities were of an intensity required for health benefits; a single Wii activity session can result in positive mood changes and the Wii interface is generally acceptable and appropriate for this older age adult group. Further randomized controlled and longer term intervention trials are needed to determine the effectiveness of exergame activity programmes.

Can balance in children with cerebral palsy improve through use of an activity promoting computer game?

This study aimed to evaluate if use of an activity promoting computer game, used in the home (Nintendo Wii Fit; Nintendo Co Ltd, Japan), could influence balance related outcome measures in children with cerebral palsy. Eighteen children with hemiplegic or diplegic cerebral palsy were recruited for the study. A randomised cross-over design was used with children tested at baseline, after five weeks of playing Wii Fit games and after five weeks without any intervention. Outcome measures of interest included: performance on the modified sensory organisation test, reactive balance test and rhythmic weight shift test. No significant difference was observed between testing occasions for any of the balance measures investigated (p > 0.05). Our results suggest that use of a Nintendo Wii balance board and Wii Fit software for a minimum of thirty minutes per day in the patient's own home, over a five week period, is not effective as a balance training tool in children with cerebral palsy.

Motion games improve balance control in stroke survivors: A preliminary study based on the principle of constraint-induced movement therapy

Stroke patients with hemiparesis often exhibit an asymmetrical weight distribution, with the paretic leg providing less support and less weight-shift activity than the sound leg does. For upper-limb hemiparesis constraint-induced movement therapy (CIMT), where the sound limb is constrained and the patient is forced to use the paretic limb, has proven to be one of the most effective rehabilitation methods. However, this method has not been successfully modified for balance rehabilitation, since hard constraints on the lower limb are difficult to impose and can increase the risk of patient injuries. Here we introduce a novel approach that encourages stroke survivors to use the paretic leg for weight-shifting tasks during balance control training in a virtual reality setting. We recorded motion signals from each leg in real time and streamed modified versions of these signals to the Nintendo Wii Fit gaming system. By independently manipulating the influence of each leg during game play, we successfully forced the stroke survivors to increase the use of the paretic leg. Our preliminary clinical trial, including three patients with hemiparesis in the chronic phase, found that one-week of training improved patients’ ability to maneuver their center of pressure (COP) during a tracking task. More encouragingly, patient’s weight distributions became more symmetrical. These initial results suggest that manipulating control gains during VR rehabilitation may allow the principles of CIMT to be applied during balance training in stroke survivors.

Use of Nintendo Wii Fit™ in the rehabilitation of outpatients following total knee replacement: a preliminary randomised controlled trial

ObjectivesTo determine whether Nintendo Wii Fit™ is an acceptable adjunct to physiotherapy treatment in the rehabilitation of balance, lower extremity movement, strength and function in outpatients following total knee replacement. DesignPreliminary randomised controlled trial. SettingOutpatient department of a rehabilitation hospital. ParticipantsAdult outpatients following total knee replacement. InterventionsThe study group received a physiotherapy session followed by 15minutes of Wii Fit gaming activities. The games encouraged lateral and multidirectional weight shifting, and provided visual feedback regarding postural balance. The control group received a physiotherapy session followed by 15minutes of lower extremity strengthening and balance training exercises. Main outcome measuresLength of outpatient rehabilitation, 2-minute walk test, knee range of motion, timed standing, Activity-specific Balance Confidence Scale, Lower Extremity Functional Scale and Numeric Pain Rating Scale, all measured on admission and every 2 weeks until discharge. A patient satisfaction survey was completed at discharge. ResultsSeventeen males (34%) and 33 females (66%) with a mean age of 68 (standard deviation 11) years participated in the study. No significant differences in age, gender, days since surgery or length of outpatient rehabilitation were found between the groups. In addition, there were no significant differences in pain (P=0.220), knee flexion (P=0.951), knee extension (P=0.492), walking speed (P=0.855), timed standing tasks (P=0.289), Lower Extremity Functional Scale (P=0.079), Activity-specific Balance Confidence Scale (P=0.523) or patient satisfaction with therapy services (P=0.201) between the groups. ConclusionsWii Fit is potentially acceptable as an adjunct to physiotherapy intervention for outpatients following total knee replacement, provided the games chosen challenge balance and postural control, and use the lower extremities. Further research is needed to establish whether video games as a therapy adjunct increase patient motivation and compliance with rehabilitation goals.ClinicalTrials.gov ID: NCT01548664.

Novel Approaches to Obesity Prevention: Effects of Game Enjoyment and Game Type on Energy Expenditure in Active Video Games

Some active video games have been found to promote physical activity adherence because of enjoyment. However, many active games are exercise themed, which may interfere with the distracting properties that make game-based exercise more enjoyable than traditional exercise. This study compared exercise-themed and game-themed active games to investigate differences in energy expenditure and enjoyment. Young adults (N = 100, 50 female, 55 overweight, aged 18-35 years) played two of four Wii Fit games (one aerobic game and one balance game per person) for 10 min each. Of the two aerobic games, one was exercise themed (jogging) and the other was game themed (hula hooping). Both balance games were game themed. Energy expenditure and enjoyment were measured. After adjustment for gender and weight, aerobic games produced 2.70 kcal/kg(-1)/h(-1) (95% confidence interval 2.41, 3.00) greater energy expenditure than balance games (p < .001), but balance games were more enjoyable (p < .001). In aerobic games, jogging produced greater energy expenditure than hula hooping in normal-weight and male participants (p < .001); in overweight and female participants, no differences were found (p > .17). Hula hooping was enjoyed more than jogging (p = .008). Enjoyment predicted energy expenditure in aerobic games (B = 0.767, p = .010). Aerobic games produced greater energy expenditure but lower enjoyment than balance games, and a game-themed aerobic game was found more enjoyable than an exercise-themed aerobic game. Integrating more strenuous activity into entertaining games instead of games that simply simulate exercise may be a fruitful avenue for active game development.

Validity and Reliability of Nintendo Wii Fit Balance Scores

Interactive gaming systems have the potential to help rehabilitate patients with musculoskeletal conditions. The Nintendo Wii Balance Board, which is part of the Wii Fit game, could be an effective tool to monitor progress during rehabilitation because the board and game can provide objective measures of balance. However, the validity and reliability of Wii Fit balance scores remain unknown. To determine the concurrent validity of balance scores produced by the Wii Fit game and the intrasession and intersession reliability of Wii Fit balance scores. Descriptive laboratory study. Sports medicine research laboratory. Forty-five recreationally active participants (age = 27.0 ± 9.8 years, height = 170.9 ± 9.2 cm, mass = 72.4 ± 11.8 kg) with a heterogeneous history of lower extremity injury. Participants completed a single-limb-stance task on a force plate and the Star Excursion Balance Test (SEBT) during the first test session. Twelve Wii Fit balance activities were completed during 2 test sessions separated by 1 week. Postural sway in the anteroposterior (AP) and mediolateral (ML) directions and the AP, ML, and resultant center-of-pressure (COP) excursions were calculated from the single-limb stance. The normalized reach distance was recorded for the anterior, posteromedial, and posterolateral directions of the SEBT. Wii Fit balance scores that the game software generated also were recorded. All 96 of the calculated correlation coefficients among Wii Fit activity outcomes and established balance outcomes were interpreted as poor (r < 0.50). Intrasession reliability for Wii Fit balance activity scores ranged from good (intraclass correlation coefficient [ICC] = 0.80) to poor (ICC = 0.39), with 8 activities having poor intrasession reliability. Similarly, 11 of the 12 Wii Fit balance activity scores demonstrated poor intersession reliability, with scores ranging from fair (ICC = 0.74) to poor (ICC = 0.29). Wii Fit balance activity scores had poor concurrent validity relative to COP outcomes and SEBT reach distances. In addition, the included Wii Fit balance activity scores generally had poor intrasession and intersession reliability.

What Are the Benefits of a Commercial Exergaming Platform for College Students? Examining Physical Activity, Enjoyment, and Future Intentions

Traditional videogames contribute to sedentary behaviors; in contrast, exergaming is a relatively new concept that uses videogames to promote exercise during game play. Nintendo Wii Fit is a commercially popular exergaming platform geared toward improving fitness, however, limited empirical evidence related to the physical and mental benefits of the Wii Fit platform currently exist. Therefore, the purpose of this study was to investigate possible physical and motivational benefits of Nintendo Wii Fit. A repeated measures design was used with 30 college-aged students to explore physical activity, enjoyment, and future intentions of physical activity associated with Wii Fit exergames. Data supported the efficacy of Wii Fit Basic Run to consistently produce moderate to vigorous physical activity across participants. Future intentions were higher for exergaming compared with generic exercise and obese individuals enjoyed exergaming more than generic physical activity. The Basic Run Wii Fit game provided opportunities for accumulating moderate to vigorous physical activity that provided motivational benefits to these participants, especially those classified as obese. Future research should examine the ability of Wii Fit exergames to produce physical activity and motivation over time.

Home-based balance training programme using Wii Fit with balance board for Parkinsons´s disease: A pilot study

To evaluate the effects of a home-based balance training programme using visual feedback (Nintendo Wii Fit game with balance board) on balance and functional abilities in subjects with Parkinson's disease, and to compare the effects with a group of paired healthy subjects. Ten subjects with moderate Parkinson's disease and 8 healthy elderly subjects. Subjects participated in a 6-week home-based balance training programme using Nintendo Wii Fit and balance board. Baseline measures were taken before training for the Sit-to-Stand test (STST), Timed-Up-and-Go (TUG), Tinetti Performance Oriented Mobility Assessment (POMA), 10-m walk test, Community Balance and Mobility assessment (CBM), Activities-specific Balance and Confidence scale (ABC), unipodal stance duration, and a force platform. All measurements were taken again after 3 and 6 weeks of training. The Parkinson's disease group significantly improved their results in TUG, STST, unipodal stance, 10-m walk test, CBM, POMA and force platform at the end of the 6-week training programme. The healthy subjects group significantly improved in TUG, STST, unipodal stance and CBM. This pilot study suggests that a home-based balance programme using Wii Fit with balance board could improve static and dynamic balance, mobility and functional abilities of people affected by Parkinson's disease.

The effects of Nintendo Wii Fit training on gait speed, balance, functional mobility and depression in one person with Parkinson’s disease

A 69 year old male with idiopathic Parkinson’s disease participated in a 60-minute, bi-weekly training program using the Nintendo Wii fit gaming system. Pre-test/post-test assessments included: 1) The Timed up and go (TUG), 2) The Berg Balance scale (BBS), 3) Self selected gait speed, 4) Fall history, and 5) Geriatric Depression Scale (GDS). After 8 weeks, the subject’s BBS score increased from 31 to 42 (35% improvement), the TUG decreased from 36.5 seconds to 24.1 seconds (34% improvement), gait speed increased from .26 m/s to .37 m/s (42% improvement) and GDS scores remained unchanged. The Nintendo Wii Fit may be a viable alternative to independent exercise programs for people diagnosed with idiopathic PD.

Nintendo Wii Sports and Wii Fit Game Analysis, Validation, and Application to Stroke Rehabilitation

Background: Interactive video gaming has become ubiquitous in the practice of rehabilitation. The Nintendo Wii is one such system. Interactive gaming can promote intensive task-based therapy in a manner that is motivating for the user. Widespread enthusiasm for consoles and their games prompted us to analyze the games for their rehabilitation elements related to improving balance and mobility for individuals poststroke. Purpose: The purpose of this article is to provide a game analysis for clinical application and evaluation of the game elements for research on interactive video gaming. Methods: Using a team of game players and raters, 5 tables (1 for the Wii Sports and 4 for the Wii Fit) were developed and validated. The tables consist of 3 categories: game description, impairments targeted (strength, endurance, balance, and coordination), and feedback provided (knowledge of performance [KP] and knowledge of results [KR]). Two domain content experts established face validity. Construct validity was performed by 2 therapist-raters who had more than 15 years’ clinical experience and postgraduate training in motor learning. Observations about the games including the fidelity of the interfaces, the nature of the feedback, and some of the challenges to adapting the games for rehabilitation are presented. Results: An 80% agreement between raters set as the criterion for establishing the construct validity was met for feedback evaluation. There was 100% agreement on impairment ratings. Games provide a greater amount of KR compared with KP. Conclusion: Given the preponderance of KR, therapists will need to monitor motor performance. Adaptation of interactive video consoles for rehabilitation requires careful evaluation of the games’ attributes using relevant rehabilitation construits.

Evaluation of Exercise Intensity and Energy Expenditure of Wii Fit Games

The increasing trend of obesity and participation in daily gaming and technology use has lead the video gaming industry to develop new ways for individuals to become physically active. Previous research has reported that Wii Fit meets minimal criteria for exercise intensity, but this research did not analyze individual game choice or physiological data. PURPOSE: To examine selection rate and physiological demand of individual Wii Fit activities during 30 minutes of Wii Fit play. METHODS: Twelve healthy, physically active females (21 ±1.6 years, 65.9 ±16.9 kg, 1.68 ±0.08 m, 41.2 ±7.1 ml/kg/min) completed a graded exercise test to determine level of cardiovascular fitness (VO2max) and maximum heart rate (HRmax). Following two orientation trials, participants completed 30 minutes of self-selected cardiovascular activity using the Wii Fit to assess energy expenditure, VO2, HR, rate of perceived exertion (RPE), and duration. RESULTS: Of the seven activities selected, Basic Run was significantly greater in %VO2max for all activities. Basic Run also demonstrated higher caloric utilization and absolute VO2 compared to all activities except Rhythm Boxing. Hula Hoop and Basic Step both displayed shorter game duration, 1.2 ± 0.1 and 2.1 ± 0.7 minutes respectively, and the lowest RPE scores, 7.6 ± 3.1 and 7.4 ± 2.5 respectively. Boxing was the only activity with significantly higher RPE scores, 15.0 ± 1.4. CONCLUSIONS: The increased metabolic load resulting from the Basic Run was likely a result of the increased total body movement required to run in place. Hula Hoop and Basic Step typically had the lowest values for almost all of the physiological variables. This was most likely due to the short duration of the game, resulting in less actual activity performed. Boxing was the only activity that resulted in a significantly higher RPE, despite lack of significant differences in metabolic variables. Perhaps this increased RPE is a result of the increased use of upper body musculature and the need for more powerful movements with the arms. These results suggest that interactive gaming may be used as a starting point or supplement for physical activity, but one should be mindful to select an activity that requires significant upper and lower body movement to increase intensity and energy expenditure.

Early Improvements in Wii Fit Balance Game Scores by Older Adults

The Nintendo Wii Fit gaming system has become increasingly popular for use in balance training and fall prevention in older adults. However, it is unclear how games designed primarily for younger adults transfer to this population. PURPOSE: The goal of this investigation was to examine immediate performance improvement on four games requiring different levels of physical and cognitive challenge. METHODS: Fifteen healthy older adults (8 women: age = 73.1 ± 3.7 yrs, BMI = 28.8 ± 8.1 kg/m2; 7 men: age = 79.1 ± 5.2 yrs, BMI = 25.3 ± 2.1 kg/m2 [mean ± SD]) with neither balance disorders nor video game familiarity visited the laboratory on four separate occasions. Subjects were guided through creating a Wii Fit character and learned how to use the system on the first visit, playing Penguin Slide and Table Tilt briefly. During the remaining three visits subjects played Balance Bubble (BB), Soccer Heading (SH), Obstacle Course (OC), and Tilt City (OC) in randomized 10 min. blocks separated by a rest period. The games required the ankle strategy, hip strategy, foot movement, and dual task performance (upper and lower extremities), respectively. The maximum score obtained within each block was used for analyses. RESULTS: The men were slightly older than the women (p = 0.02). When playing BB, women consistently scored 24% higher than men (p = 0.02), but neither sex improved across visits (p = 0.56). Men did not improve their scores in SH (p = 0.14), though women improved their scores by 78% to match those of the men at the last visit (p < 0.01). There were 83% and 53% increases across visits for both sexes when playing OC (p < 0.01) and TC (p = 0.02), respectively. CONCLUSIONS: Although any major conclusions from this pilot study are limited, there are some cautious conclusions that may be drawn. First, men and women differed in their performance profiles and also in their pattern of improvement across sessions which may partially be explained by age. Second, some improvements occurred across the three sessions that may be relevant for improved balance and postural stability. Third, it appears that not all Wii Fit balance games are suitable for immediate score improvement by older adults. Without early score success, some may become discouraged and discontinue playing, even if long-term use improves balance. Funded by CSU Center on Aging.

Changes in balance in older adults based on use of physical therapy vs the Wii Fit gaming system: a preliminary study

ObjectivesTo determine the effectiveness of Wii Fit training on balance control in older adults compared with physical therapy training. DesignQuasi-experimental design. ParticipantsEight males and nine females aged 53 to 91 years. Materials and methodsParticipants were divided into three groups: one group received both physical therapy training and Wii Fit training (PW group), one group received Wii Fit training alone (WI group), and one group received physical therapy training alone (PT group). Training consisted of three sessions per week for 4 weeks. Main outcomeBerg Balance Scale (all groups) and Bubble Test (PW and WI groups) scores. Statistical analysisDescriptive statistics, medians, interquartile ranges and 95% confidence intervals are reported to identify trends in balance control as a result of different types of training. ResultsAll subjects showed improvement in the Berg Balance Scale and Bubble Test scores. The PT and PW groups tended to perform better than the WI group on the Berg Balance Scale following treatment. Although the differences in the Bubble Test score were not substantial between the PW and WI groups, the PW group performed slightly better than the WI group on the Berg Balance Scale. ConclusionsWii Fit training appears to improve balance. However, physical therapy training on its own or in addition to Wii Fit training appears to improve balance to a greater extent than Wii Fit training alone.