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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Showing posts with label falls. Show all posts
Showing posts with label falls. Show all posts
Wednesday, 4 April 2012
Saturday, 17 March 2012
Activity-promoting gaming systems in exercise and rehabilitation
Matthew J. D. Taylor, PhD; Darren McCormick, BSc; Teshk Shawis, MBChB, FRCP; Rebecca Impson,
MSc; Murray Griffin, PhD
Journal of Rehabilitation Research & Development
Volume 48, Number 10, 2011 Pages 1171–1186
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Abstract—
Commercial activity-promoting gaming systems provide a potentially attractive means to facilitate exercise and rehabilitation. The Nintendo Wii, Sony EyeToy, Dance Dance Revolution, and Xbox Kinect are examples of gaming systems that use the movement of the player to control gameplay. Activity-promoting gaming systems can be used as a tool to increase activity levels in otherwise sedentary gamers and also be an effective tool to aid rehabilitation in clinical settings. Therefore, the aim of this current work is to review the growing area of activity-promoting gaming in the context of exercise, injury, and rehabilitation.
Key words: activity-promoting, Dance Dance Revolution,
exercise, falls, games, gaming systems, injury, Nintendo Wii,
rehabilitation, Sony EyeToy, Xbox Kinect.
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MSc; Murray Griffin, PhD
Journal of Rehabilitation Research & Development
Volume 48, Number 10, 2011 Pages 1171–1186
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Abstract—
Commercial activity-promoting gaming systems provide a potentially attractive means to facilitate exercise and rehabilitation. The Nintendo Wii, Sony EyeToy, Dance Dance Revolution, and Xbox Kinect are examples of gaming systems that use the movement of the player to control gameplay. Activity-promoting gaming systems can be used as a tool to increase activity levels in otherwise sedentary gamers and also be an effective tool to aid rehabilitation in clinical settings. Therefore, the aim of this current work is to review the growing area of activity-promoting gaming in the context of exercise, injury, and rehabilitation.
Key words: activity-promoting, Dance Dance Revolution,
exercise, falls, games, gaming systems, injury, Nintendo Wii,
rehabilitation, Sony EyeToy, Xbox Kinect.
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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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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, 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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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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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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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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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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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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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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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.
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
Assessing and training standing balance in older adults: A novel approach using the 'Nintendo Wii' Balance Board.
Gait Posture. 2010 Nov 17. [Epub ahead of print]
Young W, Ferguson S, Brault S, Craig C.
The School of Psychology, The Queen's University Belfast
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Abstract
Older adults, deemed to be at a high risk of falling, are often unable to participate in dynamic exercises due to physical constraints and/or a fear of falling. Using the Nintendo 'Wii Balance Board' (WBB) (Nintendo, Kyoto, Japan), we have developed an interface that allows a user to accurately calculate a participant's centre of pressure (COP) and incorporate it into a virtual environment to create bespoke diagnostic or training programmes that exploit real-time visual feedback of current COP position. This platform allows researchers to design, control and validate tasks that both train and test balance function. This technology provides a safe, adaptable and low-cost balance training/testing solution for older adults, particularly those at high-risk of falling.
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Young W, Ferguson S, Brault S, Craig C.
The School of Psychology, The Queen's University Belfast
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Abstract
Older adults, deemed to be at a high risk of falling, are often unable to participate in dynamic exercises due to physical constraints and/or a fear of falling. Using the Nintendo 'Wii Balance Board' (WBB) (Nintendo, Kyoto, Japan), we have developed an interface that allows a user to accurately calculate a participant's centre of pressure (COP) and incorporate it into a virtual environment to create bespoke diagnostic or training programmes that exploit real-time visual feedback of current COP position. This platform allows researchers to design, control and validate tasks that both train and test balance function. This technology provides a safe, adaptable and low-cost balance training/testing solution for older adults, particularly those at high-risk of falling.
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Friday, 24 September 2010
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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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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Wednesday, 21 July 2010
Validity and reliability of the Nintendo Wii Balance Board for assessment of standing balance (2010)
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Gait & Posture, Volume 31, Issue 3, March 2010, Pages 307-310
Ross A. Clarka, Adam L. Bryanta, Yonghao Puab, Paul McCrorya, Kim Bennella and Michael Hunta
Abstract
Impaired standing balance has a detrimental effect on a person's functional ability and increases their risk of falling. There is currently no validated system which can precisely quantify center of pressure (COP), an important component of standing balance, while being inexpensive, portable and widely available. The Wii Balance Board (WBB) fits these criteria, and we examined its validity in comparison with the ‘gold standard’—a laboratory-grade force platform (FP). Thirty subjects without lower limb pathology performed a combination of single and double leg standing balance tests with eyes open or closed on two separate occasions. Data from the WBB were acquired using a laptop computer. The test–retest reliability for COP path length for each of the testing devices, including a comparison of the WBB and FP data, was examined using intraclass correlation coefficients (ICC), Bland–Altman plots (BAP) and minimum detectable change (MDC). Both devices exhibited good to excellent COP path length test–retest reliability within-device (ICC = 0.66–0.94) and between-device (ICC = 0.77–0.89) on all testing protocols. Examination of the BAP revealed no relationship between the difference and the mean in any test, however the MDC values for the WBB did exceed those of the FP in three of the four tests. These findings suggest that the WBB is a valid tool for assessing standing balance. Given that the WBB is portable, widely available and a fraction of the cost of a FP, it could provide the average clinician with a standing balance assessment tool suitable for the clinical setting.
Keywords: Balance; Motor control; Movement disorder; Rehabilitation; Force plate; Biomechanics; Gait; Posture
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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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