Evaluation of Nintendo Wii Balance Board as a Tool for Measuring Postural Stability After Sport-Related Concussion

Abstract

Context: Recent changes to postconcussion guidelines indicate that postural-stability assessment may augment traditional neurocognitive testing when making return-to-participation decisions. The Balance Error Scoring System (BESS) has been proposed as 1 measure of balance assessment. A new, freely available software program to accompany the Nintendo Wii Balance Board (WBB) system has recently been developed but has not been tested in concussed patients.Objective: To evaluate the feasibility of using the WBB to assess postural stability across 3 time points (baseline and postconcussion days 3 and 7) and to assess concurrent and convergent validity of the WBB with other traditional measures (BESS and Immediate Post-Concussion Assessment and Cognitive Test [ImPACT] battery) of assessing concussion recovery.Design: Cohort study. Setting: Athletic training room and collegiate sports arena. Patients or Other Participants: We collected preseason baseline data from 403 National Collegiate Athletic Association Division I and III student-athletes participating in contact sports and studied 19 participants (age ¼ 19.2 6 1.2 years, height ¼ 177.7 6 8.0 cm, mass ¼ 75.3 6 16.6 kg, time from baseline to day 3 postconcussion ¼ 27.1 6 36.6 weeks) who sustained concussions. Main Outcome Measure(s):We assessed balance using single-legged and double-legged stances for both the BESS and WBB, focusing on the double-legged, eyes-closed stance for the WBB, and used ImPACT to assess neurocognition at 3 time points. Descriptive statistics were used to characterize the sample. Mean differences and Spearman rank correlation coefficients were used to determine differences within and between metrics over the 3 time points. Individual-level changes over time were also assessed graphically.Results: The WBB demonstrated mean changes between baseline and day 3 postconcussion and between days 3 and 7 postconcussion. It was correlated with the BESS and ImPACT for several measures and identified 2 cases of abnormal balance postconcussion that would not have been identified via the BESS.Conclusions: When accompanied by the appropriate analytic software, the WBB may be an alternative for assessing postural stability in concussed student-athletes and may provide additional information to that obtained via the BESS and ImPACT. However, verification among independent samples is required.

Effect of Taping and Virtual Reality Combined Exercise on Static and Dynamic Balance With Functional Ankle Instability

“…Of course, the authors still think that kinesio taping has positive effects, such as improving the performance of the ankle [18]. Second, Nintendo Wii Fit Plus is a tool for VR, but it was created for entertainment [19]. For example, it is difficult to set muscle strength and balanced exercise time accurately in this equipment.…”

Comparison of a Nintendo Wii balance board with a laboratory-grade force plate on measurement of transitional movements

“…Emerging, portable, inexpensive, and valid system for the quantitative assessment of human movement could represent a worthy resource for clinician and researchers. Previous studies have addressed validity and reliability of the Wii Balance Board (WBB) for assessing the kinetic characteristics of lower-limb movements (Abujaber, et al, 2015;Yamamoto & Matsuzawa, 2013) and the standing balance (Clark, et al, 2010(Clark, et al, , 2017Pagnacco, et al, 2010;Park & Lee, 2014;Pavan, et al, 2015;Sañudo, Rueda, del Pozo-Cruz, de Hoyo, & Carrasco, 2016;Sgrò, et al, 2014) in comparison with the goldstandard force plate (FP). Almost all studies found the WBB to be valid for the afore-mentioned aims but recommended to pay more attention to use WBB and FP interchangeably.…”

“…The WBB is a plate composed of four transducers that are used to acquire the forces provided above the board's surface. This device has already been compared with the gold standard force plates in terms of its usage feasibility and inter-and intra-device validity (i.e., in comparison with FPs and with the same WBB, respectively) for assessing postural control abilities (Clark, et al, 2010;Clark, Mentiplay, Pua, & Bower, 2018;Huurnink, Fransz, Kingma, & van Dieën, 2013;Merchant-Borna, et al, 2017;Pagnacco, Oggero, & Wright, 2010;Park & Lee, 2014;Pavan, Cardaioli, Ferri, Gobbi, & Carraro, 2015;Sgrò, Monteleone, Pavone, & Lipoma, 2014). Studies about intradevice reliability showed intra-class correlation coefficients ranging from poor to excellent, while inter-device validity was found excellent if the same posturography parameters were acquired from the plates.…”

An Objective Balance Error Scoring System for Sideline Concussion Evaluation Using Duplex Kinect Sensors

“…Such efforts can be divided into two main approaches: postural sway and error scoring [ 14 , 17 ]. The first has been evaluated by using force plate [ 17 , 18 , 19 ] or wearable devices [ 14 , 20 , 21 ]. Different from the scores of BESS, the metrics of postural sway are quantified by measured changes in body sway amplitude, velocity, frequency and direction of anterior-posterior, medial-lateral or trunk-rotation movements [ 20 ].…”