Comparison between clinical and instrumental assessing using Wii Fit system on balance control

The use of low-cost, commercial gaming systems for rehabilitation has received substantial attention in the last few years. Systems such as the Nintendo Wii encourage players to use natural actions to play games. The Wii systems has been integrated into rehabilitation programs and has gained the support of occupational therapists because it is easy to use and has a wide variety of games available. In this study we compare the benefits on balance control of Wii Fit use with traditional rehabilitation therapy in 15 patients (study group) with Spinal Cord Injuries (SCI) and in 15 normal subjects (control group). The performance on balance control of each subject was evaluate by the Berg Balance Scale(BBS) in order to establish the baseline. Similar measurement was repeated at the discharge. Moreover, we assess the improvements induced by the use of Wii Fit platform with quantitative posturographic analysis by means of parameters and objective metric indexes such as COP Area and Sway Path. Comparison between two groups was performed by means of paired t test and Mann Whitney test. Both groups showed improvements in the BBS and in the posturographic indexes at the discharge. Very interesting is to note that the wii fit training appears to improve much more the balance of the study group compared to the study group.

[1]  T.E. Prieto,et al.  Measures of postural steadiness: differences between healthy young and elderly adults , 1996, IEEE Transactions on Biomedical Engineering.

[2]  Gerard Jounghyun Kim,et al.  A SWOT Analysis of the Field of Virtual Reality Rehabilitation and Therapy , 2005, Presence: Teleoperators & Virtual Environments.

[3]  C. Hui-Chan,et al.  Effects of exercise on joint sense and balance in elderly men: Tai Chi versus golf. , 2004, Medicine and science in sports and exercise.

[4]  Heidi Sveistrup,et al.  Functional Balance and Dual-Task Reaction Times in Older Adults Are Improved by Virtual Reality and Biofeedback Training , 2007, Cyberpsychology Behav. Soc. Netw..

[5]  Vashti R. DeRosier,et al.  The Effect of Training with Nintendo Wii Fit Balance Programs on Measures of Balance in Older Women , 2010 .

[6]  H. Dickson,et al.  SCIM–Spinal Cord Independence Measure: a new disability scale for patients with spinal cord lesions , 1998, Spinal Cord.

[7]  J. Deutsch,et al.  Use of a Low-Cost, Commercially Available Gaming Console (Wii) for Rehabilitation of an Adolescent With Cerebral Palsy , 2008, Physical Therapy.

[8]  D. Rand,et al.  The Sony PlayStation II EyeToy: Low-Cost Virtual Reality for Use in Rehabilitation , 2008, Journal of neurologic physical therapy : JNPT.

[9]  A. Betker,et al.  Game-based Exercises for Dynamic Short-Sitting Balance Rehabilitation of People With Chronic Spinal Cord and Traumatic Brain Injuries , 2007, Physical Therapy.

[10]  J. Kleim,et al.  Sensitivity of cortical movement representations to motor experience: evidence that skill learning but not strength training induces cortical reorganization , 2001, Behavioural Brain Research.

[11]  C. Richards,et al.  The Role of Technology in Task-Oriented Training in Persons with Subacute Stroke: A Randomized Controlled Trial , 2004, Neurorehabilitation and neural repair.

[12]  M Rabuffetti,et al.  Kinematic characteristics of standing disequilibrium: reliability and validity of a posturographic protocol. , 1999, Archives of physical medicine and rehabilitation.

[13]  Heidi Sveistrup,et al.  Motor rehabilitation using virtual reality , 2004, Journal of NeuroEngineering and Rehabilitation.

[14]  A Cappello,et al.  An improved technique for the extraction of stochastic parameters from stabilograms. , 2000, Gait & posture.

[15]  V. Fung,et al.  Use of Nintendo Wii Fit™ in the rehabilitation of outpatients following total knee replacement: a preliminary randomised controlled trial. , 2012, Physiotherapy.

[16]  J. Carr,et al.  Neurological Rehabilitation: Optimizing Motor Performance , 2003 .

[17]  Hamid Bateni,et al.  Changes in balance in older adults based on use of physical therapy vs the Wii Fit gaming system: a preliminary study. , 2012, Physiotherapy.

[18]  Thomas W. Malone,et al.  Heuristics for designing enjoyable user interfaces: Lessons from computer games , 1982, CHI '82.

[19]  D Cunningham,et al.  Virtual reality: a wholistic approach to rehabilitation. , 1999, Studies in health technology and informatics.

[20]  F. Horak,et al.  Postural perturbations: new insights for treatment of balance disorders. , 1997, Physical therapy.

[21]  S. Flynn,et al.  Feasibility of Using the Sony PlayStation 2 Gaming Platform for an Individual Poststroke: A Case Report , 2007, Journal of neurologic physical therapy : JNPT.

[22]  Maureen K. Holden,et al.  Virtual Environments for Motor Rehabilitation: Review , 2005, Cyberpsychology Behav. Soc. Netw..

[23]  G. Kwakkel Impact of intensity of practice after stroke: issues for consideration. , 2012, Disability and rehabilitation.

[24]  Angelo Cappello,et al.  Identification of distinct characteristics of postural sway in Parkinson's disease: A feature selection procedure based on principal component analysis , 2006, Neuroscience Letters.

[25]  Ciaran Scott Hill Developing Psychomotor Skills the Wii Way , 2009, Science.

[26]  A. Betker,et al.  Video game-based exercises for balance rehabilitation: a single-subject design. , 2006, Archives of physical medicine and rehabilitation.

[27]  D. Nelson,et al.  The effects of an occupationally embedded exercise on bilaterally assisted supination in persons with hemiplegia. , 1996, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[28]  B. E. Maki,et al.  Measuring balance in the elderly: validation of an instrument. , 1992, Canadian journal of public health = Revue canadienne de sante publique.