Effectiveness of a Wii balance board-based system (eBaViR) for balance rehabilitation: a pilot randomized clinical trial in patients with acquired brain injury

Abstract

BackgroundAcquired brain injury (ABI) is the main cause of death and disability among young adults. In most cases, survivors can experience balance instability, resulting in functional impairments that are associated with diminished health-related quality of life. Traditional rehabilitation therapy may be tedious. This can reduce motivation and adherence to the treatment and thus provide a limited benefit to patients with balance disorders. We present eBaViR (easy Balance Virtual Rehabilitation), a system based on the Nintendo® Wii Balance Board® (WBB), which has been designed by clinical therapists to improve standing balance in patients with ABI through motivational and adaptative exercises. We hypothesize that eBaViR, is feasible, safe and potentially effective in enhancing standing balance.MethodsIn this contribution, we present a randomized and controlled single blinded study to assess the influence of a WBB-based virtual rehabilitation system on balance rehabilitation with ABI hemiparetic patients. This study describes the eBaViR system and evaluates its effectiveness considering 20 one-hour-sessions of virtual reality rehabilitation (n = 9) versus standard rehabilitation (n = 8). Effectiveness was evaluated by means of traditional static and dynamic balance scales.ResultsThe final sample consisted of 11 men and 6 women. Mean ± SD age was 47.3 ± 17.8 and mean ± SD chronicity was 570.9 ± 313.2 days. Patients using eBaViR had a significant improvement in static balance (p = 0.011 in Berg Balance Scale and p = 0.011 in Anterior Reaches Test) compared to patients who underwent traditional therapy. Regarding dynamic balance, the results showed significant improvement over time in all these measures, but no significant group effect or group-by-time interaction was detected for any of them, which suggests that both groups improved in the same way. There were no serious adverse events during treatment in either group.ConclusionsThe results suggest that eBaViR represents a safe and effective alternative to traditional treatment to improve static balance in the ABI population. These results have encouraged us to reinforce the virtual treatment with new exercises, so an evolution of the system is currently being developed.

Posturography using the Wii Balance Board™

“…It is important to highlight that the hardware architecture, the acquisition of the COP data, and the post-acquisition processing can vary greatly with different posturography systems, thus restricting their comparability [25]. Our results support the clinical use of the WBB-based system as an alternative to laboratory-grade systems, while benefiting from the low-cost and portability of the WBB [5] and the free-of-charge posturography [12].…”

“…The off-the-shelf Nintendo® Wii Balance Board™ (WBB) is an inexpensive and portable force platform aimed toward allowing users to interact with videogames through postural changes [5]. Interestingly, the WBB has been shown to have validity and reliability similar to the laboratory grade force platforms used in posturography systems [6,7], whose cost is several orders of magnitude higher.…”

“…Interestingly, the WBB has been shown to have validity and reliability similar to the laboratory grade force platforms used in posturography systems [6,7], whose cost is several orders of magnitude higher. This fact has motivated an increasing number of studies involving the WBB either as a rehabilitation [5] or as an assessment tool [6,8]. Estimations of the path length and the speed of the COP using the WBB have generally shown excellent correlation with those using laboratory-grade platforms [6,7,9,10], across different activities and populations [6,8,10].…”

Virtual-Reality Balance Training with a Video-Game System Improves Dynamic Balance in Chronic Stroke Patients

“…However, traditional balance training schemes rely on the repetition of specific movements, which many patients find aimless and boring, resulting in reduced motivation and compliance with training programs (Gil-Gomez et al 2011).…”

“…Thus, readily available, cheap equipment, such as active video game systems are currently being used for rehabilitative intervention (Miyachi et al 2010;Saposnik et al 2010b;Gil-Gomez et al 2011;Hurkmans et al 2011;Mouawad et al 2011).…”