Home-based balance training using Wii Fit™: a pilot randomised controlled trial with mobile older stroke survivors

Abstract

BackgroundSeveral studies have reported that using the Wii™ Balance Board can provide added value regarding balance (re-)training in neurological diseases. However, for the large group of mobile older stroke survivors, there is no evidence regarding the feasibility of an unsupervised Wii™ Balance Board training in the home setting. The aim of this study was to investigate the feasibility of a home-based Wii™ balance training for these patients and to identify methodological challenges for randomised controlled trials in the future.MethodsWe conducted a pilot randomised controlled trial with two intervention arms in participants’ homes. Mobile stroke survivors (aged 60 years or above; 12 weeks after discharge from hospital) received a 6-week (once per week) supervised balance training at the study centre, followed by a 6-week (three times per week) unsupervised balance training at home. We used the Nintendo Wii™ Balance Board for one intervention arm and conventional balance exercises for the other intervention arm. Feasibility was assessed by recruiting rates, appropriateness of assessments regarding sensitivity to changes and acceptance of the intervention by the participants.ResultsIn two German hospital stroke units, 349 stroke survivors were screened over a period of 6 months, 91 were eligible and 52 were interested. Twelve weeks after discharge, 14 participants agreed and 11 completed the intervention (7 men and 4 women, mean age 74 years). The Berg Balance Scale and Dynamic Gait Index showed ceiling effects already at baseline measure. The participants in both intervention arms evaluated the unsupervised training positively and feasible for self-application. No falls or injuries occurred over the intervention period, while the required scope of the exercises could largely be achieved.ConclusionsIn this pilot study, the recruitment of participants and the chosen assessments were not satisfactory due to selection bias and corresponding ceiling effects. However, the two home-based balance interventions proved feasible for mobile older stroke survivors with low functional limitations.Trial registrationClinicalTrials.gov, NCT02251470. Registered 29 September 2014

Immersive Virtual Reality in Stroke Patients as a New Approach for Reducing Postural Disabilities and Falls Risk: A Case Series

“…In comparison with other modalities of VR (semi-immersive and non-immersive) such as robotics or Wii games where the patients are trained in a sitting position, our study is based on an immersive VR training protocol which was conducted with the patient in a standing position, increasing the global neuromuscular response. In this sense, previous published studies have used the Wii exergaming to train balance and motor function in stroke patients [21]. Although these studies have shown positive and interesting results, our data suggest that training balance and the global motor function in a standing position is also effective to improve balance after stroke.…”

“…Nevertheless, the majority of published works have used non-immersive VR therapies, such as Wii exergames for balance training [21,22]. Recently, improved versions of immersive VR have become available for clinical and research purposes in physical rehabilitation.…”

Kinect-based rapid movement training to improve balance recovery for stroke fall prevention: a randomized controlled trial

“…Telerehabilitation and interactive body motion detection technology using Kinect and Wii Fit have become more popular [ 1 , 2 ]. The COVID-19 is a global pandemic started in the end of 2019 and is still ongoing at the preparation of this paper.…”

“…With the advancement of depth camera and body tracking technology and algorithm to identify body joint movements in 3D space (e.g. Realsense, Microsoft Kinect and Microsoft Azure Kinect, Wii Fit), many rehabilitation centers have adapted these affordable 3D motion capture technology to enhance their clinical practice [ 2 , 13 ]. These technologies are being used to make rehabilitation methods more personalized, easy-to-use, and interactive than repetitive and high-intensity training in the traditional setting.…”

Comparação dos efeitos de um treinamento motor em realidade virtual realizado com e sem intervenção do fisioterapeuta sobre a função motora, o equilíbrio e a marcha de indivíduos com sequelas crônicas de AVE: um ensaio clínico randomizado

“…Alguns estudos citam a possibilidade do uso destes sistemas no ambiente domiciliar (onde o treino poderia ser realizado de forma autônoma pelos próprios indivíduos pós-AVE sem a necessidade de um fisioterapeuta direcionando o treinamento), ou ainda citam a possibilidade da aplicação dos exergames em reabilitação sem a supervisão de um fisioterapeuta, reduzindo custos das terapias por não requerer supervisão constante do profissional (Yatar e Yildirim, 2015;Gibbons et al, 2016;Sugarman e Weisel-Eichler, 2009;Deutsch et al, 2009;Viñas-Diz e Sobrido-Prieto, 2016;Laver et al, 2015;Fu et al, 2015). O treino realizado no ambiente domiciliar utilizando este sistema em indivíduos com AVE, no entanto, foi mais estudado com enfoque na função de membro superior (Perrochon et al, 2019) e as evidências ainda não são conclusivas com relação à abordagem voltada ao equilíbrio (Golla et al, 2018;Laufer et al, 2014).…”