Feasibility, safety, acceptability, and functional outcomes of playing Nintendo Wii Fit Plus™ for frail elderly: study protocol for a feasibility trial

Abstract

BackgroundFrailty can be defined as a medical syndrome with multiple causes and contributors, characterized by diminished strength and endurance and reduced physiological function that increases the vulnerability to develop functional dependency and/or death. Studies have shown that the most commonly studied exercise protocol for frail older adults is the multimodal training. Interactive video games (IVGs) involve tasks in virtual environments that combine physical and cognitive demands in an attractive and challenging way. The aim of this study will be to evaluate the feasibility, safety, acceptability, and functional outcomes of playing Nintendo Wii Fit PlusTM (NWFP) for frail older adults.Methods/designThe study is a randomized controlled, parallel group, feasibility trial. Participants will be randomly assigned to the experimental group (EG) and control group (CG). The EG will participate in 14 training sessions, each lasting 50 min, twice a week. In each training session, the participants will play five games, with three attempts at each game. The first attempt will be performed with the assistance of a physical therapist to correct the movements and posture of the patients and subsequent attempts will be performed independently. Scores achieved in the games will be recorded. The participants will be evaluated by a blinded physical therapist at three moments: before and after intervention and 30 days after the end of the intervention (follow-up). We will assess the feasibility, acceptability, safety, and clinical outcomes (postural control, gait, cognition, quality of life, mood, and fear of falling).DiscussionDue to the deficiencies in multiple systems, studies have shown that multimodal interventions including motor-cognitive stimulation can improve the mobility of frail elderly adults. IVGs, among them the NWFP, are considered as a multimodal motor-cognitive intervention that can potentially improve motor and cognitive functions in the frail elderly. However, there is still no evidence in the literature that proves the feasibility, safety, acceptability, and functional outcomes of this intervention in frail elderly individuals.Trial registrationBrazilian Registry of Clinical Trials (RBR-823rst). World Health Organization Trial Registration Data Set (Additional file 1).Electronic supplementary materialThe online version of this article (10.1186/s40814-017-0184-1) contains supplementary material, which is available to authorized users.

A single-arm feasibility study of community-delivered Baduanjin (Qigong practice of the eight Brocades) training for frail older adults

“…Different interventions to reduce frailty have been studied [ 8 – 10 ]. Recent reviews highlighted the importance of physical exercise in reducing frailty and improving function in prefrail/frail older adults [ 11 , 12 ].…”

Effectiveness of Virtual Reality Systems to Improve the Activities of Daily Life in Older People

“…The remaining fourteen studies did not design any intervention for the control group. Only five studies carried out a follow-up after the intervention [ 38 , 39 , 41 , 42 , 43 ].…”

“… Tollar 2019 [ 37 ] Level I RCT n = 83 EC-CYC = 27 EC-EXE = 28 CC = 28 69.6 (66–72) 53% Female >60 years; >24 MMSE; >40 BDI; mobility difficulty Hospital Somogy, Hungary Xbox or bicycle ergometer 5 weeks 5 times/week Usual routine activities 6MWT; SE-ADL; DGI; MAP; SF-36; WOMAC No follow-up Xbox and cycling improved general health-related QoL and walking capacity. Xbox improved the SE-ADL (7.3%) Gomes 2019 [ 41 ] Level I RCT n = 30 EC = 15 CC = 15 84 (78–90) 93% female >60 years; able to walk independently; normal or corrected visual acuity; good hearing; no previous experience with VR Sao Paulo Brazil Hospital Nintendo Wii Fit 7 weeks 2 times/week Advice regarding the importance of physical activity FGA; MoCA; FES 4 weeks after intervention VR Wii-Fit was feasible, acceptable and safe for frail older adults and improved their postural control and gait. There were no effects on cognition, mood or fear of falling.…”

Effects of a Nintendo Wii exercise program versus Tai Chi Chuan on standing balance in older adults: a preliminary study

“…However, the NWBB has been extensively used in many populations with different pathologies, but no specific assessments of CoP sway and mV as reported in this study have been found in the literature. Furthermore, recently two study protocols13, 14 ) focused on assessing the effects of the Nintendo Wii have been published, which highlights the importance and validity of this topic in geriatric research.…”