A “Wii” bit of fun: The effects of adding Nintendo Wii^®Bowling to a standard exercise regimen for residents of long-term care with upper extremity dysfunction

Abstract

The aims of this randomized, single-blind crossover trial were to investigate the effect of adding a simulated bowling video game via the Nintendo Wii(®) gaming system to the standard exercise regimen of cognitively intact residents of long-term care (LTC) with upper extremity dysfunction and to identify individual characteristics that might predict improvement. Residents (n=34) were recruited through two LTC facilities in southwestern Ontario and were randomized into a standard exercise (SG) or standard exercise plus Wii bowling (Wii) arm. After 4 weeks of intervention, the groups were crossed over to the opposite arm. Outcomes included measures of pain intensity and bothersomeness, physical activity enjoyment, and a six-item measure of functional capacity designed specifically for residents of LTC. Results suggest that subjects improved on all outcomes from pre- to postintervention but that only enjoyment of activity showed a significant difference between the SG and Wii groups. Effect sizes (Cohen's d) ranged from small (0.30 for bothersomeness) to large (1.77 for functional capacity). Responders, defined as those subjects who reported any degree of improvement following the Wii intervention, were less likely to complain of stiffness or shoulder symptoms and were more likely to complain of hand symptoms than non-responders. Limitations in interpretation and recommendations for future research are presented.

Therapeutic Uses of Active Videogames: A Systematic Review

“…52 A study comparing ''Wii Bowling'' with standard exercise found that functional capacity, but not pain intensity, improved among long-term care patients with upper extremity dysfunction. 54 The long-term care patients in this study reported that Wii play was more enjoyable than the standard exercise.…”

“…Five studies examined AVG play among people with extremity dysfunction or amputations, using the ''Wii Fit,'' 51-53 ''Wii Sports,'' 54,55 and ''Dance Dance Revolution'' adapted for upper extremity play. 55 A case study of two older adult amputees found improved energy efficiency and reduced need for an assistive device, 53 and a case study of three young adults who used wheelchairs with a range of upper extremity limitations (none in a case of spina bifida and moderate to severe in cases of cerebral palsy) found a significant increase in energy expenditure.…”

Sensor-Based Interactive Balance Training with Visual Joint Movement Feedback for Improving Postural Stability in Diabetics with Peripheral Neuropathy: A Randomized Controlled Trial

“…Additionally, some of the commercial exergaming devices detect only the movement of the controller and do not necessarily require participants to exert whole-body movements, which might not be ideal adaptive approaches for rehabilitation [14,22]. Furthermore, the options available to tailor the game for specific population groups or individuals are limited, as visual feedback is intended for game or fun purposes only [39,40] rather than accuracy of performance or feedback on motor errors that enhances learning. Biomechanical validation studies have also reported limited accuracies of such systems [41].…”

Impact of Serious Games on Health and Well-being of Elderly: A Systematic Review

“…Study showed some improvements in balance after exergame program but it was not superior compared to walking exercise program. [40] also examined the impacts on upper extremity range of motion and functioning but for longterm patients. Pendulum-style movement exercises are used in shoulder rehabilitation when the joint is stiff and range of motion decreased.…”