Feasibility, Safety, and Enjoyment during Wii Balance Board Exergame Training among Individuals with Sub-acute Stroke

Abstract

Introduction. Nintendo® Wii is a non-immersive virtual reality platform that works integrated with the Wii Balance Board as a biofeedback system for balance rehabilitation among post-stroke patients. Objective. Primary objective was to evaluate the feasibility of employing Wii Balance Board training as a standalone treatment approach in clinical practice for sub-acute stroke patients. The secondary objective was to assess the enjoyment status during Wii Balance Board training and to calculate effect size for definitive study. Method. The study design was pilot randomized control trial. We recruited 20 sub-acute stroke patients using a block randomization technique. The participants in the experimental group received Wii Balance Board training for 12 sessions up to 2 weeks. The control group participants received standard physiotherapy treatments for standing balance for 12 sessions until 2 weeks. Outcome measures were clinical-log documentation for feasibility testing, Exergame Enjoyment Questionnaire, mini-BESTest, and FIMs. Results. The study’s enrollment and retention rate was respectively 80% (n = 20) and 70% in each group (n = 7). The incidence rate of adverse events from Wii Fit training was reported to be 40% (n = 4), along with a moderate enjoyment rate (mean±sd=50.10 ± 14.69; n = 10). The experimental intervention did not offer significant benefits over control intervention (p = 0.539, 0.622; Cohen’s d = -0.280, -0.224; 95% CI: -1.158 to 0.605, -1.101 to 0.658). Conclusion. The Wii Balance Board-based exergames training can be considered a feasible and safe balance training approach among sub-acute stroke patients. However, exergames cannot replace standard care balance rehabilitation due to poor efficacy in short term.