‘Wii-habilitation’ and robotic exoskeletons: technology in physiotherapy - 2010

Royal College of Surgeons in Ireland Student Medical Journal 2010; 3: 70-74.

Aideen Henry(1), Aileen Barrett(2)

Author affilitations
1RCSI physiotherapy student
2Practice Education Co-ordinator, School of Physiotherapy, RCSI

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Abstract
For mobility-impaired patients, gait retraining is an integral part of the rehabilitation programme. Manual assisted body weight support treadmill training (BWSTT) has been a major focus of research and is considered one of the primary methods of gait retraining. In recent years the focus of research has shifted to robotic assisted treadmill training, which is as efficacious as manual assisted BWSTT but is considered more cost-effective with respect to personnel and labour. The Lokomat® is a machine that provides robotic assisted treadmill training by means of a robotic gait orthosis, body weight support system and treadmill. Manufactured by Hocoma in Switzerland, it has been the subject of intense media attention since it was introduced to the US in 2001. Similar attention has been given to the Nintendo WiiTM gaming system for its potential role in rehabilitation. Although not specifically designed for use in the medical arena, the Nintendo WiiTM has been linked with functional rehabilitation benefits in a variety of patient groups. The aim of this paper is to review the clinical applications of the Lokomat® and Nintendo WiiTM, and to provide an analysis of the advantages and disadvantages associated with each as a physiotherapy modality in rehabilitation.

Keywords: Physiotherapy, treadmill training, Lokomat®, virtual reality, Nintendo WiiTM, gait re-education.

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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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Reliability of an inexpensive and portable dynamic weight bearing asymmetry assessment system incorporating dual Nintendo Wii Balance Boards - May 2011

Gait Posture.

2011 May 11.

Clark RA, McGough R, Paterson K.

Source: Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, 202 Berkeley Street, Parkville, VIC 3010, Australia.

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Abstract
Weight bearing asymmetry (WBA) during dynamic tasks is prevalent in a variety of clinical populations. However, accurate measurement has previously been out of reach of the clinician due to the costly equipment and technical expertise required.

The aim of this study was to assess the test-retest reliability of WBA data obtained using an inexpensive and simple to use dual force plate system incorporating unmodified Nintendo Wii Balance Boards (NWBB) and customized software. A secondary outcome measure, individual limb COP path velocity, which represents the postural sway under each limb was also examined.

Twenty-three participants performed squats both with and without visual WBA feedback on two separate occasions. Weight-bearing asymmetry as a percentage of body mass and individual limb center of pressure (COP) path velocity were recorded during these trials, with intraclass correlation coefficient (ICC(2,1)) analysis performed to assess test-retest reliability. This system provided reliable values for both outcome measures when performed with and without real-time visual feedback of WBA (ICC(2,1) range=0.75-0.91).

In conclusion, recording WBA and COP path velocity data using NWBB is reliable. Given that tens of millions of NWBB have been sold worldwide, and that reprogramming them for clinical purposes is within the reach of most software developers, similar systems may soon become commonplace in the clinical setting.

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Potential of Wii-Rehabilitation for Persons Recovering From Acute Stroke (2009)

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The Potential of Wii-Rehabilitation for Persons Recovering From Acute Stroke by: Sinead Brosnan, OTR/L
Published in Special Interest Section Quarterly: Physical Disabilities
Vol 32, No 1, March 2009
Published by The American Occupational Therapy Association, Inc