Wii Fit Balance Board Playing Improves Balance and Gait in Parkinson Disease

Abstract

Objective To assess the effect of exercise training by using the Nintendo Wii Fit video game and balance board system on balance and gait in adults with Parkinson disease (PD). Design A prospective interventional cohort study. Setting An outpatient group exercise class. Participants Ten subjects with PD, Hoehn and Yahr stages 2.5 or 3, with a mean age of 67.1 years; 4 men, 6 women. Interventions The subjects participated in supervised group exercise sessions 3 times per week for 8 weeks by practicing 3 different Wii balance board games (marble tracking, skiing, and bubble rafting) adjusted for their individualized function level. The subjects trained for 10 minutes per game, a total of 30 minutes training per session. Main Outcome Measurements Pre-and postexercise training, a physical therapist evaluated subjects’ function by using the Berg Balance Scale, Dynamic Gait Index, and Sharpened Romberg with eyes open and closed. Postural sway was assessed at rest and with tracking tasks by using the Wii balance board. The subjects rated their confidence in balance by using the Activities-specific Balance Confidence scale and depression on the Geriatric Depression Scale. Results Balance as measured by the Berg Balance Scale improved significantly, with an increase of 3.3 points (P = .016). The Dynamic Gait Index improved as well (mean increase, 2.8; P = .004), as did postural sway measured with the balance board (decreased variance in stance with eyes open by 31%; P = .049). Although the Sharpened Romberg with eyes closed increased by 6.85 points and with eyes opened by 3.3 points, improvements neared significance only for eyes closed (P = .07 versus P = .188). There were no significant changes on patient ratings for the Activities-specific Balance Confidence (mean decrease, −1%; P = .922) or the Geriatric Depression Scale (mean increase, 2.2; P = .188). Conclusions An 8-week exercise training class by using the Wii Fit balance board improved selective measures of balance and gait in adults with PD. However, no significant changes were seen in mood or confidence regarding balance.

Exercise and rehabilitation delivered through exergames in older adults: An integrative review of technologies, safety and efficacy

“…The primary aim of the reviewed studies was to evaluate the potential effect of gaming/VR exercise on balance, either alone (9,12,(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46), in combination with other physical abilities such as strength or mobility (11,13,(47)(48)(49)(50)(51), or in combination with falls or fear of falling, cognition, quality of life, or user experience (52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62). Seven studies investigated the effect of gaming/VR exercise on gait parameters (63)(64)(65)(66)(67)(68)(69), and six studies examined the effectiveness with regard to different physical functions and associated fall risk (10,(70)(71)(72)…”

Efeito de video games ativos sobre a capacidade funcional e o humor de idosos: revisão sistemática e meta-análise

“…Alguns estudos encontraram resultados significantes na redução dos sintomas depressivos 41,42 , e de solidão, e na melhora do humor positivo 15 . Em contraste, outros estudos não encontraram diferenças significantes no humor após o treinamento com o VGA 25,27,35 . No que diz respeito às variáveis relacionadas à capacidade funcional, o tamanho de efeito observado para o equilíbrio foi entre d= 0,1 e -4,6 [26][27][28][30][31][32][33] , para a força muscular dos membros inferiores entre d= 0,3 e 3,0 [33][34][35] e para a resistência aeróbia, foi d= 0,2 9 .…”

“…No que diz respeito às variáveis relacionadas à capacidade funcional, o tamanho de efeito observado para o equilíbrio foi entre d= 0,1 e -4,6 [26][27][28][30][31][32][33] , para a força muscular dos membros inferiores entre d= 0,3 e 3,0 [33][34][35] e para a resistência aeróbia, foi d= 0,2 9 . Para a mobilidade funcional, os tamanhos de efeito foram entre d= -0,3 e -2,6 26,36 , para a confiança no equilíbrio d= 0,7 37 , e para a melhora na marcha dinâmica entre d= 0,2 e d= 3,5 27,33 . Para a redução no risco de quedas, os tamanhos de efeito foram entre d= 0,7 e d= 1,8 34,37 .…”

“…Os estudos que avaliaram a capacidade funcional encontraram melhoras em diversas variáveis, como no equilí-brio [24][25][26][27][28][29][30][31][32][33] , na força muscular dos membros inferiores [33][34][35][36] na resistência aeróbia 9 , na mobilidade funcional 24,26,36 , na confiança em relação ao equilíbrio durante a realização do exercício físico 25,36,37 , na redução do risco dequedas 34,37 e na melhora da marcha dinâmica 27,33,36 . Alguns estudos, no entanto, não encontraram melhoras significantes no equilíbrio, após o exercício físico com VGA [38][39][40] (Tabela 2).…”

“…Além disso, outros estudos não encontraram diferenças significantes no humor após o treinamento com o VGA 25,27,35 (Tabela 3).…”