Showing posts with label elderly. Show all posts
Showing posts with label elderly. Show all posts

Thursday, 25 October 2012

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

Physiotherapy. 2012 Sep;98(3):211-6. Epub 2011 Apr 29.

Bateni H.

School of Allied Health and Communicative Disorders, Physical Therapy Program, Northern Illinois University, 1425 W. Lincoln Hwy, DeKalb, IL 60115-2828, USA

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Abstract 
OBJECTIVES: To determine the effectiveness of Wii Fit training on balance control in older adults compared with physical therapy training.
DESIGN: Quasi-experimental design.
PARTICIPANTS: Eight males and nine females aged 53 to 91 years.
MATERIALS AND METHODS: Participants 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 OUTCOME: Berg Balance Scale (all groups) and Bubble Test (PW and WI groups) scores.
STATISTICAL ANALYSIS: Descriptive statistics, medians, interquartile ranges and 95% confidence intervals are reported to identify trends in balance control as a result of different types of training.
RESULTS: All 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.
CONCLUSIONS: Wii 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.

Copyright © 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

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Wednesday, 24 October 2012

Motor learning, retention and transfer after virtual-reality-based training in Parkinson's disease--effect of motor and cognitive demands of games: a longitudinal, controlled clinical study.

Physiotherapy. 2012 Sep;98(3):217-23. Epub 2012 Jul 9.

dos Santos Mendes FA, Pompeu JE, Modenesi Lobo A, Guedes da Silva K, Oliveira Tde P, Peterson Zomignani A, Pimentel Piemonte ME.

Department of Neuroscience and Behaviour, Institute of Psychology, University of São Paulo, São Paulo, Brazil.

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Abstract 
OBJECTIVES: To evaluate the learning, retention and transfer of performance improvements after Nintendo Wii Fit™ training in patients with Parkinson's disease and healthy elderly people.
DESIGN: Longitudinal, controlled clinical study.
PARTICIPANTS: Sixteen patients with early-stage Parkinson's disease and 11 healthy elderly people.
INTERVENTIONS: Warm-up exercises and Wii Fit training that involved training motor (shifts centre of gravity and step alternation) and cognitive skills. A follow-up evaluative Wii Fit session was held 60 days after the end of training. Participants performed a functional reach test before and after training as a measure of learning transfer.
MAIN OUTCOME MEASURES: Learning and retention were determined based on the scores of 10 Wii Fit games over eight sessions. Transfer of learning was assessed after training using the functional reach test.
RESULTS: Patients with Parkinson's disease showed no deficit in learning or retention on seven of the 10 games, despite showing poorer performance on five games compared with the healthy elderly group. Patients with Parkinson's disease showed marked learning deficits on three other games, independent of poorer initial performance. This deficit appears to be associated with cognitive demands of the games which require decision-making, response inhibition, divided attention and working memory. Finally, patients with Parkinson's disease were able to transfer motor ability trained on the games to a similar untrained task.
CONCLUSIONS: The ability of patients with Parkinson's disease to learn, retain and transfer performance improvements after training on the Nintendo Wii Fit depends largely on the demands, particularly cognitive demands, of the games involved, reiterating the importance of game selection for rehabilitation purposes.

Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

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Wednesday, 25 April 2012

Interactive virtual reality Wii in geriatric day hospital: A study to assess its feasibility, acceptability and efficacy.

Geriatrics & Gerontology International
2012 Apr 2

Chan TC, Chan F, Shea YF, Lin OY, Luk JK, Chan FH. Source Department of Medicine, Division of Geriatrics, Queen Mary Hospital, The University of Hong Kong, Department of Medicine and Geriatrics, Fung Yiu King Hospital, Hong Kong, China

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Abstract
Aim:  Rehabilitation using interactive virtual reality Wii (Wii-IVR) was shown to be feasible in patients with different medical problems, but there was no study examining its use in a geriatric day hospital (GDH). The aim of the present study was to test the feasibility, acceptability and efficacy of Wii-IVR in GDH.

Methods:  It was a clinical trial with matched historic controls. Patients of a GDH were recruited to participate in Wii-IVR by playing "Wii Fit". Participants used a Wii controller to carry out movements involved in an arm ergometer. Each participant received eight sessions of Wii-IVR in addition to conventional GDH rehabilitation. Feasibility was assessed by the total time receiving Wii-IVR, the percentage of maximal heart rate reserve (%MHR) and Borg perceived exertion scale (BS) after participating in Wii-IVR. %MHR and BS were compared with those after carrying out an arm ergometer for the same duration. Acceptability was assessed by an interviewer-administered questionnaire. Efficacy was assessed by comparing improvements in Functional Independence Measure (FIM) between participants and matched historic controls, who received conventional GDH rehabilitations only.

Results:  A total of 30 patients completed the study. Participants completed a total of 1941 min of event-free Wii-IVR. The mean %MHR was 15.9% ± 9.9% and the mean BS was 7.9 ± 2.3. There was no significant difference in %MHR and BS between participating in Wii-IVR and arm ergometer. Most participants found Wii-IVR similar to the arm ergometer, and would like to continue Wii-IVR if they had Wii at home. Improvements in FIM of participants were significantly more than that of historic controls.

Conclusions:  Wii-IVR in GDH was feasible and most participants accepted it. Participants had more improvements in FIM.

Wednesday, 4 April 2012

Clinical Use of Nintendo Wii(TM) Bowling Simulation to Decrease Fall Risk in an Elderly Resident of a Nursing Home: A Case Report

Journal of Geriatric Physical Therapy: 2009 - Volume 32 - Issue 4 - p 174–180 Case Report

 Authors: Clark, Robert PT, ; Kraemer, Theresa PT, PhD,

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Abstract

Purpose:: Of the estimated 1.7 million residents of nursing homes in the United States, approximately half fall annually; and 11% of these sustain injury. This is twice the rate for persons dwelling in the community. By addressing fall risk, physical therapists have an opportunity to reduce falls which are the leading cause of injury deaths, as well as the most common cause of nonfatal injuries for older adults in the United States. This case report examines the effect of a novel interactive video game intervention to address balance dysfunction in an elderly resident of a nursing home who was at risk for falls.

Case Description:: The patient is an 89‐year‐old resident diagnosed with an unspecified balance disorder and a history of multiple falls. Self reports of gait abnormalities, scores on several clinical measures, and her fall history classified her as having substantial risk for future falls.

Intervention:: A nontraditional approach to balance training, employing the Nintendo Wii bowling simulation, was used as intervention for this patient's balance disorder.

Outcomes:: After 6 one‐hour treatment sessions, the patient's Berg Balance Score improved from 48 to 53. On the Dynamic Gait Index, the patient improved her score from 19 to 21. The patient's Timed Up and Go Test improved from 14.9 to 10.5 seconds, all suggesting a reduced risk of falling. The patient's ABC Score improved from 88 to 90%.

Conclusion:: Physical therapy intervention, using the Nintendo Wii bowling simulation, may have decreased fall risk for this individual.

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Monday, 27 February 2012

Wii Fit® training vs. Adapted Physical Activities: which one is the most appropriate to improve the balance of independent senior subjects? A randomized controlled study

Clinical Rehabilation 2012 Feb 9. [Epub ahead of print]

Toulotte C, Toursel C, Olivier N.
Universite Lille Nord de France, Faculte des sciences du sport et de l'education physique, France.

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Abstract
Objective: To compare the effectiveness of three protocols (Adapted Physical Activities, Wii Fit(®), Adapted Physical Activities + Wii Fit(®)) on the balance of independent senior subjects. Design: Case comparison study.Settings: Healthy elderly subjects living in independent community dwellings. Subjects: Thirty-six subjects, average age 75.09 ± 10.26 years, took part in this study, and were randomly assigned to one of the four experimental groups: G1 followed an Adapted Physical Activities training programme, while the second group (G2) participated in Wii Fit(®) training and the third one (G3) combined both methods. There was no training for the fourth group (G4). All subjects trained once a week (1 hour) for 20 weeks and were assessed before and after treatment. Main measures: The Tinetti test, unipedal tests and the Wii Fit(®) tests. Results: After training, the scores in the Tinetti test decreased significantly (P < 0.05) for G1, G2 and G3 respectively in static conditions and for G1 and G3 in dynamic conditions. After training, the performance in the unipedal tests decreased significantly (P < 0.05) for G1 and G3. The position of the centre of gravity was modified significantly (P < 0.05) for G2 and G3. Conclusion: After 20 training sessions, G1 (Adapted Physical Activities), G2 (Wii Fit(®)) and G3 (Adapted Physical Activities and Wii Fit(®)) improved their balance. In addition, G1 and G3 increased their dynamic balance. The findings suggest that Adapted Physical Activities training limits the decline in sensorial functions in the elderly.

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Sunday, 26 February 2012

Using the Nintendo Wii as an Intervention in a Falls Prevention Group

Journal of American Geriatrics Society. 2012 Feb;60(2):385-7

Griffin M, Shawis T, Impson R, McCormick D, Taylor MJ.
Department of Biological Sciences, University of Essex.

No abstract is available for this article.

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Saturday, 25 February 2012

The Use of Nintendo Wii with Long-Term Care Residents

Journal of the American Geriatrics Society
Volume 59, Issue 12, pages 2393–2395, December 2011
Kirsten Brandt AB, Miguel A. Paniagua MD, FACP

No abstract available

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Tuesday, 20 December 2011

A Pilot Study of Wii Fit Exergames to Improve Balance in Older Adults

Journal of Geriatric Physical Therapy:
October/December 2011 - Volume 34 - Issue 4 - p 161–167
Agmon, Maayan PT, PhD, MA, BA; Perry, Cynthia K. PhD, ARNP; Phelan, Elizabeth MD, MS; Demiris, George PhD; Nguyen, Huong Q. PhD

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Abstract
Purpose: To determine the safety and feasibility of using Nintendo Wii Fit exergames to improve balance in older adults.

Methods: Seven older adults aged 84 (5) years with impaired balance (Berg Balance Scale [BBS] score < 52 points) were recruited from 4 continuing care retirement communities to participate in a single group pre- and postevaluation of Wii Fit exergames. Participants received individualized instructions (at least 5 home visits) on playing 4 exergames (basic step, soccer heading, ski slalom, and table tilt) and were asked to play these games in their homes at least 30 minutes 3 times per week for 3 months and received weekly telephone follow-up. They also completed a paper log of their exergame play and rated their enjoyment immediately after each session. Participants completed the BBS, 4-Meter Timed Walk test, and the Physical Activity Enjoyment Scale at baseline and 3 months. Semistructured interviews were conducted at the 3-month evaluation.

Results: Participants safely and independently played a mean of 50 sessions, median session duration of 31 minutes. Two of the games were modified to ensure participants' safety. Participants rated high enjoyment immediately after exergame play and expressed experiencing improved balance with daily activities and desire to play exergames with their grandchildren. Berg Balance Scores increased from 49 (2.1) to 53 (1.8) points (P = .017). Walking speed increased from 1.04 (0.2) to 1.33 (0.84) m/s (P = .018).

Conclusions: Use of Wii Fit for limited supervised balance training in the home was safe and feasible for a selected sample of older adults. Further research is needed to determine clinical efficacy in a larger, diverse sample and ascertain whether Wii Fit exergames can be integrated into physical therapy practice to promote health in older adults.

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Saturday, 12 November 2011

Effects of an Interactive Computer Game Exercise Regimen on Balance Impairment in Frail Community-Dwelling Older Adults: A Randomized Controlled Trial

Published online before print - 28 July 2011
Physical Therapy October 2011 vol. 91 no. 10 1449-1462
Tony Szturm, Aimee L. Betker, Zahra Moussavi, Ankur Desai andValerie Goodman

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Abstract

Background Due to the many problems associated with reduced balance and mobility, providing an effective and engaging rehabilitation regimen is essential to progress recovery from impairments and to help prevent further degradation of motor skills.

Objectives The purpose of this study was to examine the feasibility and benefits of physical therapy based on a task-oriented approach delivered via an engaging, interactive video game paradigm. The intervention focused on performing targeted dynamic tasks, which included reactive balance controls and environmental interaction.

Design This study was a randomized controlled trial.

Setting The study was conducted in a geriatric day hospital.

Participants Thirty community-dwelling and ambulatory older adults attending the day hospital for treatment of balance and mobility limitations participated in the study.

Interventions Participants were randomly assigned to either a control group or an experimental group. The control group received the typical rehabilitation program consisting of strengthening and balance exercises provided at the day hospital. The experimental group received a program of dynamic balance exercises coupled with video game play, using a center-of-pressure position signal as the computer mouse. The tasks were performed while standing on a fixed floor surface, with progression to a compliant sponge pad. Each group received 16 sessions, scheduled 2 per week, with each session lasting 45 minutes. Measurements Data for the following measures were obtained before and after treatment: Berg Balance Scale, Timed “Up & Go” Test, Activities-specific Balance Confidence Scale, modified Clinical Test of Sensory Interaction and Balance, and spatiotemporal gait variables assessed in an instrumented carpet system test.

Results Findings demonstrated significant improvements in posttreatment balance performance scores for both groups, and change scores were significantly greater in the experimental group compared with the control group. No significant treatment effect was observed in either group for the Timed “Up & Go” Test or spatiotemporal gait variables.

Limitations The sample size was small, and there were group differences at baseline in some performance measures. Conclusion Dynamic balance exercises on fixed and compliant sponge surfaces were feasibly coupled to interactive game-based exercise. This coupling, in turn, resulted in a greater improvement in dynamic standing balance control compared with the typical exercise program. However, there was no transfer of effect to gait function.

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Monday, 24 October 2011

Is the Nintendo Wii Fit really acceptable to older people?: A discrete choice experiment

BMC Geriatrics 2011, 11:64

Kate Laver , Julie Ratcliffe , Stacey George , Leonie Burgess and Maria Crotty
Published: 20 October 2011

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Abstract (provisional)
Background Interactive video games such as the Nintendo Wii Fit are increasingly used as a therapeutic tool in health and aged care settings however, their acceptability to older people is unclear. The aim of this study was to determine the acceptability of the Nintendo Wii Fit as a therapy tool for hospitalised older people using a discrete choice experiment (DCE) before and after exposure to the intervention.

Methods A DCE was administered to 21 participants in an interview style format prior to, and following several sessions of using the Wii Fit in physiotherapy. The physiotherapist prescribed the Wii Fit activities, supervised and supported the patient during the therapy sessions. Attributes included in the DCE were: mode of therapy (traditional or using the Wii Fit), amount of therapy, cost of therapy program and percentage of recovery made. Data was analysed using conditional (fixed-effects) logistic regression.

Results Prior to commencing the therapy program participants were most concerned about therapy time (avoiding programs that were too intensive), and the amount of recovery they would make. Following the therapy program, participants were more concerned with the mode of therapy and preferred traditional therapy programs over programs using the Wii Fit.

Conclusions The usefulness of the Wii Fit as a therapy tool with hospitalised older people is limited not only by the small proportion of older people who are able to use it, but by older people's preferences for traditional approaches to therapy. Mainstream media portrayals of the popularity of the Wii Fit with older people may not reflect the true acceptability in the older hospitalised population.

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Monday, 5 September 2011

Feasibility and Benefit of Using the Nintendo Wii Fit for Balance Rehabilitation in an Elderly Patient Experiencing Recurrent Falls

JOURNAL OF STUDENT PHYSICAL THERAPY RESEARCH | 2010 VOLUME 2, NUMBER 1, ARTICLE 2

Tony Pigford, DPT
Director of Outpatient Physical Therapy, Duplin General Hospital – Kenansville, NC
A. Williams Andrews, PT, EdD, NCS
Associate Professor, Department of Physical Therapy Education, Elon University – Elon, N


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ABSTRACT
Introduction: The purpose of this case report was to examine whether a balance training program utilizing the
Nintendo Wii Fit platform could improve dynamic balance control in an elderly patient with balance impairments.
Also, the investigators sought to determine whether the motivational aspect of the video games would stimulate the
patient’s desire to participate in the balance rehabilitation program. Case Description: An elderly patient with a
recent history of falls underwent two weeks of balance training utilizing the Wii Fit platform along with other
traditional therapeutic interventions. Pre-intervention and post-intervention outcome measures were recorded. For
this report, the selected outcome measures were: Berg Balance Scale, Activities-specific Balance Confidence Scale,
Timed Up and Go, and gait speed. Outcomes: Post-intervention, the patient demonstrated improvements in all of
the selected balance outcome measures. During the intervention, the patient demonstrated a high level of
cooperation resulting in increased time spent performing balance activities. Conclusions: This case report gives
insight on how the Wii Fit was combined with more traditional physical therapy interventions to enhance an elderly
patient’s participation in the interventions and improve balance performance.

Thursday, 1 September 2011

On the use of the Wii Fit™ in reducing falling risk factors and improving balance for the elderly

Kinesitherapie Revue (KINESITHERAPIE REVUE), 2010 Nov(107): 41-5 (13 ref)

Grosjean, Aurélie ; Fabbri, Emmeline ; Feldheim, Eric ; Snoeck, Thyl ; Amand, Marc ; Keuterickx, Claude ; Balestra, Costantino

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Abstract
Background: The Nintendo® game console, called Wii Fit[TM], distinguishes itself from the other game consoles. In fact, it has many exercises that engage all body parts. We undertook this study to evaluate the usefulness of this type of game console by means of its included programs provided to improve balance and risk of falls among the elderly.

Method: The main evaluation tools that we used are specific tests for balance and walking, and the Nintendo® Wii Fit[TM] console. This study is based on a sample population of 21 people aged over 65 years (mean age: 85,67 ± 6,14 years) and divided into a control group and experimental group.

Results: Our results show a highly significant improvement between the control and experimental group after six weeks of training on the game console.

Level of evidence: 4 (Not randomized comparative study)

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Tuesday, 16 August 2011

Active Video Gaming to Improve Balance in the Elderly

Studies in Health Technology and Informatics 2011;167:159-64.

Claudine J.C. Lamoth, Simone R. Caljouw, Klaas Postema


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ABSTRACT
The combination of active video gaming and exercise (exergaming) is suggested to improve elderly people's balance, thereby decreasing fall risk. Exergaming has been shown to increase motivation during exercise therapy, due to the enjoyable and challenging nature, which could support long-term adherence for exercising balance. However, scarce evidence is available of the direct effects of exergaming on postural control. Therefore, the aim of the study was to assess the effect of a six-week videogame-based exercise program aimed at improving balance in elderly people. Task performance and postural control were examined using an interrupted time series design. Results of multilevel analyses showed that performance on the dot task improved within the first two weeks of training. Postural control improved during the intervention. After the intervention period task performance and balance were better than before the intervention. Results of this study show that healthy elderly can benefit from a videogame-based exercise program to improve balance and that all subjects were highly motivated to exercise balance because they found gaming challenging and enjoyable.

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Wednesday, 10 August 2011

Evaluation of the Frails' Fall Efficacy by Comparing Treatments (EFFECT) on reducing fall and fear of fall in moderately frail older adults: study protocol for a randomised control trial

Trials. 2011; 12: 155.
Published online 2011 June 18

Boon Chong Kwok, Kaysar Mamun, Manju Chandran and Chek Hooi Wong

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Abstract

Background

Falls are common in frail older adults and often result in injuries and hospitalisation. The Nintendo® Wii™ is an easily available exercise modality in the community which has been shown to improve lower limb strength and balance. However, not much is known on the effectiveness of the Nintendo® Wii™ to improve fall efficacy and reduce falls in a moderately frail older adult. Fall efficacy is the measure of fear of falling in performing various daily activities. Fear contributes to avoidance of activities and functional decline.

Methods
This randomised active-control trial is a comparison between the Nintendo WiiActive programme against standard gym-based rehabilitation of the older population. Eighty subjects aged above 60, fallers and non-fallers, will be recruited from the hospital outpatient clinic. The primary outcome measure is the Modified Falls Efficacy Scale and the secondary outcome measures are self-reported falls, quadriceps strength, walking agility, dynamic balance and quality of life assessments.

Discussions
The study is the first randomised control trial using the Nintendo Wii as a rehabilitation modality investigating a change in fall efficacy and self-reported falls. Longitudinally, the study will investigate if the interventions can successfully reduce falls and analyse the cost-effectiveness of the programme.


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Sunday, 5 June 2011

Changes in balance in older adults based on use of physical therapy vs the Wii Fit gaming system: a preliminary study - April 2011

Physiotherapy : Available online 29 April 2011.

Hamid Bateni

School of Allied Health and Communicative Disorders, Physical Therapy Program, Northern Illinois University, 1425 W. Lincoln Hwy, DeKalb, IL 60115-2828, USA

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Abstract

Objectives
To determine the effectiveness of Wii Fit training on balance control in older adults compared with physical therapy training.

Design
Quasi-experimental design.

Participants
Eight males and nine females aged 53 to 91 years.

Materials and methods
Participants 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 outcome
Berg Balance Scale (all groups) and Bubble Test (PW and WI groups) scores.

Statistical analysis
Descriptive statistics, medians, interquartile ranges and 95% confidence intervals are reported to identify trends in balance control as a result of different types of training.

Results
All 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.

Conclusions
Wii 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.

Keywords: Wii Fit; Postural balance; Berg Balance Scale; Computerised gaming systems

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Thursday, 28 April 2011

The Reliability and Preliminary Validity of Game-Based Fall Risk Assessment in Community-Dwelling Older Adults.

Geriatric Nursing
2011 Apr 16. [Epub ahead of print]
Yamada M, Aoyama T, Nakamura M, Tanaka B, Nagai K, Tatematsu N, Uemura K, Nakamura T, Tsuboyama T, Ichihashi N.

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Abstract
The purpose of this study was to examine whether the Nintendo Wii Fit program could be used for fall risk assessment in healthy, community-dwelling older adults. Forty-five community-dwelling older women participated in this study. The "Basic Step" and "Ski Slalom" modules were selected from the Wii Fit game program. The following 5 physical performance tests were performed: the 10-m walk test under single- and dual-task conditions, the Timed Up and Go test under single- and dual-task conditions, and the Functional Reach test. Compared with the faller group, the nonfaller group showed a significant difference in the Basic Step (P < .001) and a nonsignificant difference in the Ski Slalom (P = .453). The discriminating criterion between the 2 groups was a score of 111 points on the Basic Step (P < .001). The Basic Step showed statistically significant, moderate correlations between the dual-task lag of walking (r = -.547) and the dual-task lag of the Timed Up and Go test (r = -.688). These results suggest that game-based fall risk assessment using the Basic Step has a high generality and is useful in community-dwelling older adults.
Copyright © 2011 Mosby, Inc. All rights reserved.

Friday, 3 December 2010

Lessons learned: Staff perceptions of the Nintendo Wii as a health promotion tool within an aged-care and disability service.

Health promotion journal of Australia, 2010 Dec;21(3):189-95.

Higgins HC, Horton JK, Hodgkinson BC, Muggleton SB.

Blue Care, Milton, Queensland.

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Abstract
Issue addressed: Enhancing opportunities for all older people to be physically and mentally active is an imperative in our ageing society. Lessons learned from the use of the Nintendo Wii within Queensland agedcare and disability services were assembled through eliciting staff perceptions regarding the usefulness of Wii technology within their centres.

Methods: Telephone interviews were conducted with direct care staff in 53 centres that had been using the Wii technology for at least three months. Content analysis of interview data identified the major response patterns raised by staff.

Results: Staff noted that Wii activities were easy to master for more able clients and that there was minimal risk to clients. Staff reported that these activities provided health promoting physical benefits (mobility, range of motion, dexterity, coordination, distraction from pain) and psychosocial gains (social engagement, self-esteem, mastery, ability to pacify challenging behaviours) and were a useful adjunct to other care practices within these aged-care and disabilities services.

Conclusions: Staff believed that Wii activities provided purposeful and meaningful opportunities to promote wellbeing for aged and disabled clients within an aged-care and disability service. However, Wii activities were less successful with clients who had significant cognitive and/or physical disabilities.

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Thursday, 30 September 2010

EXercising with Computers in Later Life (EXCELL) - pilot and feasibility study of the acceptability of the Nintendo® WiiFit in community fallers

BMC Research Notes 2010, 3:238

Marie A Williams , Roy L Soiza , Alison McE Jenkinson and Alison Stewart

Published: 13 September 2010

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Abstract

Background
Falls management programmes have been instituted to attempt to reduce falls. This pilot study was undertaken to determine whether the Nintendo® WiiFit was a feasible and acceptable intervention in community-dwelling older fallers.

Findings
Community-dwelling fallers over 70 years were recruited and attended for computer-based exercises (n = 15) or standard care (n = 6). Balance and fear of falling were assessed at weeks 0, 4 and 12. Participants were interviewed on completion of the study to determine whether the intervention was acceptable.

Eighty percent of participants attended 75% or more of the exercise sessions. An improvement in Berg Score was seen at four weeks (p = 0.02) and in Wii Age at 12 weeks (p = 0.03) in the intervention group. There was no improvement in balance scores in the standard care group.

Conclusion
WiiFit exercise is acceptable in self-referred older people with a history of falls. The WiiFit has the potential to improve balance but further work is required.

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Friday, 24 September 2010

A "Wii" bit of fun: The effects of adding Nintendo Wii Bowling to a standard exercise regimen for residents of long term care.

Physiother Theory Pract. 2010 Aug 10.

Hsu JK, Thibodeau R, Wong SJ, Zukiwsky D, Cecile S, Walton DM.

Physiotherapist, Merivale Professional Physiotherapy Centre, Ottawa, Ontario, Canada.

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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((R)) 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.

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EXercising with Computers in Later Life (EXCELL) - pilot and feasibility study of the acceptability of the Nintendo WiiFit in community.

BMC Res Notes. 2010 Sep 13;3(1):238.

Williams MA, Soiza RL, Jenkinson AM, Stewart A.

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ABSTRACT:


BACKGROUND: Falls management programmes have been instituted to attempt to reduce falls. This pilot study was undertaken to determine whether the Nintendo(R)WiiFit was a feasible and acceptable intervention in community-dwelling older fallers.

FINDINGS: Community-dwelling fallers over 70 years were recruited and attended for computer-based exercises (n=15) or standard care (n=6). Balance and fear of falling were assessed at weeks 0, 4 and 12. Participants were interviewed on completion of the study to determine whether the intervention was acceptable. Eighty percent of participants attended 75% or more of the exercise sessions. An improvement in Berg Score was seen at four weeks (p = 0.02) and in Wii Age at 12 weeks (p = 0.03) in the intervention group. There was no improvement in balance scores in the standard care group.

CONCLUSION: WiiFit exercise is acceptable in self-referred older people with a history of falls. The WiiFit has the potential to improve balance but further work is required. Trial Registration ClinicalTrials.gov - NCT01082042.

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